| Certificate Number | 343 | | Date Issued |
| Child Given Name | |
Huntley | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 16 Jul 1888 |
Slater Story Co IA | Place of Birth |
| Father's Given Name | Earnest |
Huntley | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Illinois | 32 | Father's Age |
| Mother's Given Name | Lizzie | Arnold | Mother's Maiden Name |
| Mother's Surname | Huntley | Slater Story Co IA | Mother's Residence |
| Mother's Nationality | | Creston Union Co IA | Mother's Birth Place |
| Mother's Age | 30 | 1 | Number of Child This Mother |
| Medical Attendant's Name | E.A. Rawson | Slater IA | Medical Attendant's Address |