| Certificate Number | 344 | | Date Issued |
| Child Given Name | |
Lehmann | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 02 Jun 1889 |
Slater Story Co IA | Place of Birth |
| Father's Given Name | Robt C. |
Lehmann | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Germany | 32 | Father's Age |
| Mother's Given Name | Ollie | Hughes | Mother's Maiden Name |
| Mother's Surname | | Slater Story Co IA | Mother's Residence |
| Mother's Nationality | | Ms? | Mother's Birth Place |
| Mother's Age | 23 | 3 | Number of Child This Mother |
| Medical Attendant's Name | E.A. Rawson | Slater IA | Medical Attendant's Address |