| Certificate Number | 237 | | Date Issued |
| Child Given Name | Nellie Irene |
Jones | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 09 Feb 1888 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Wm H. |
Jones | Father's Surname |
| Father's Occupation | Dairy Worker | | Father's Nationality |
| Father's Birth Place | England | 38 | Father's Age |
| Mother's Given Name | Sophia | Pipes | Mother's Maiden Name |
| Mother's Surname | | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 34 | 7 | Number of Child This Mother |
| Medical Attendant's Name | Geo. Stitzell | Nevada IA | Medical Attendant's Address |