| Certificate Number | 233 | | Date Issued |
| Child Given Name | |
Lowe | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 26 Dec 1885 |
| Place of Birth |
| Father's Given Name | George G. |
Lowell | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | New York | | Father's Age |
| Mother's Given Name | Estella | Bell | Mother's Maiden Name |
| Mother's Surname | Lowell | Polk Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Medical Attendant's Name | J.W. Brown | Cambridge IA | Medical Attendant's Address |
| Certificate Signer's Name | J.W. Brown | Cambridge IA | Certificate Signer's Address |
| Returned by Name | J.W. Brown | | |