| Child Given Name | Bertha Jane |
Hankins | Child Surname |
| Child Sex | Female |
| Child Race |
| Date of Birth | 18 Apr 1884 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | John |
Hankins | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Illinois | 38 | Father's Age |
| Mother's Given Name | Sarah Catherine | Shaffer | Mother's Maiden Name |
| Mother's Surname | Hankins | Collins Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Pennsylvania | Mother's Birth Place |
| Mother's Age | 34 | | Number of Child This Mother |
| Certificate Signer's Name | Ida E. Eberly | Colorado | Certificate Signer's Address |