Certificate Number | 70 | | Date Issued |
Child Given Name | J.G. |
Lounsbury | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 28 Oct 1880 |
Sherman Twp Story Co IA | Place of Birth |
Father's Given Name | J.H. |
Lounsbury | Father's Surname |
Father's Occupation | Farmer | American | Father's Nationality |
Father's Birth Place | Ohio | 25 | Father's Age |
Mother's Given Name | A.F. | Danskin | Mother's Maiden Name |
Mother's Surname | Lounsbury | Sherman Twp Story Co IA | Mother's Residence |
Mother's Nationality | Canadian | Canada | Mother's Birth Place |
Mother's Age | 20 | 2 | Number of Child This Mother |
Medical Attendant's Name | Geo. Frazee | Colo IA | Medical Attendant's Address |
Certificate Signer's Name | Geo. Frazee | Colo IA | Certificate Signer's Address |
Returned by Name | Geo. Frazee | | |