| Certificate Number | 299 | | Date Issued |
| Child Given Name | Susanna |
McAllister | Child Surname |
| Child Sex | Female |
| Child Race |
| Date of Birth | 04 Apr 1881 |
Union Twp Story Co IA | Place of Birth |
| Father's Given Name | George S. |
McAllister | Father's Surname |
| Father's Occupation | Farmer | Canadian | Father's Nationality |
| Father's Birth Place | Canada | 34 | Father's Age |
| Mother's Given Name | Isabella | McGuire | Mother's Maiden Name |
| Mother's Surname | McAllister | Union Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Illinois | Mother's Birth Place |
| Mother's Age | 34 | 7 | Number of Child This Mother |
| Medical Attendant's Name | Eliza McCallister | | Medical Attendant's Address |
| Certificate Signer's Name | Eliza McCallister | | Certificate Signer's Address |
| Returned by Name | D.D. Hayes M.D. | | |