| Child Given Name | Inger Serrine |
Haaland | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 11 Jan 1888 |
McCallsburg Story Co IA | Place of Birth |
| Father's Given Name | Andrew J. |
Haaland | Father's Surname |
| Father's Occupation | Railroad | Norwegian | Father's Nationality |
| Father's Birth Place | Norway | 40 | Father's Age |
| Mother's Given Name | Aseline | Kellevaag | Mother's Maiden Name |
| Mother's Surname | Haaland | McCallsburg Story Co IA | Mother's Residence |
| Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
| Mother's Age | 37 | 2 | Number of Child This Mother |
| Certificate Signer's Name | Jennie Baier | Ames IA | Certificate Signer's Address |