| Certificate Number | 363 | | Date Issued |
| Child Given Name | Floyd David |
Lyons | Child Surname |
| Child Sex | Male |
| Child Race |
| Date of Birth | 17 Apr 1882 |
Milford Twp Story Co IA | Place of Birth |
| Father's Given Name | Jacob M. |
Lyons | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Indiana | 34 | Father's Age |
| Mother's Given Name | Martha | McDaniel | Mother's Maiden Name |
| Mother's Surname | Lyons | Milford Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 19 | 1 | Number of Child This Mother |
| Medical Attendant's Name | H.M. Templeton | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | H.M. Templeton | Ames IA | Certificate Signer's Address |
| Returned by Name | H.M. Templeton | | |