Certificate Number | 530 | | Date Issued |
Child Given Name | |
Kegley | Child Surname |
Child Sex | Female |
W | Child Race |
Date of Birth | 29 Mar 1887 |
Ames Story Co IA | Place of Birth |
Father's Given Name | Cary B. |
Kegley | Father's Surname |
Father's Occupation | Business | | Father's Nationality |
Father's Birth Place | Iowa | 30 | Father's Age |
Mother's Given Name | Augusta | Furguson | Mother's Maiden Name |
Mother's Surname | Kegley | Ames Story Co IA | Mother's Residence |
Mother's Nationality | | Wisconson | Mother's Birth Place |
Mother's Age | 28 | 3 | Number of Child This Mother |
Medical Attendant's Name | H.M. Templeton | Ames IA | Medical Attendant's Address |