| Child Given Name | Hosea |
Jondall | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 25 Nov 1887 |
Roland Story Co IA | Place of Birth |
| Father's Given Name | John Henry |
Jondall | Father's Surname |
| Father's Occupation | Carpenter | Norwegian | Father's Nationality |
| Father's Birth Place | Norway | 25 | Father's Age |
| Mother's Given Name | Mary | Svensen | Mother's Maiden Name |
| Mother's Surname | Jondall | Roland Story Co IA | Mother's Residence |
| Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
| Mother's Age | 20 | 2 | Number of Child This Mother |
| Certificate Signer's Name | Mary Jondall | | Certificate Signer's Address |