| Certificate Number | 178 | | Date Issued |
| Child Given Name | Abby Luverne |
Kistler | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 24 May 1888 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | W.H. |
Kistler | Father's Surname |
| Father's Occupation | Carpenter | | Father's Nationality |
| Father's Birth Place | Pennsylvania | 42 | Father's Age |
| Mother's Given Name | Huldah A. | Hork | Mother's Maiden Name |
| Mother's Surname | | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Massachusets | Mother's Birth Place |
| Mother's Age | 42 | 3 | Number of Child This Mother |
| Medical Attendant's Name | E.B. Plumb | Ames IA | Medical Attendant's Address |