| Certificate Number | 503 | | Date Issued |
| Child Given Name | Edwin J. |
Murray | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 27 Nov 1882 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Edwin J. |
Murray | Father's Surname |
| Father's Occupation | Stock Dealer | American | Father's Nationality |
| Father's Birth Place | New York | 34 | Father's Age |
| Mother's Given Name | Emma A. | Forbes | Mother's Maiden Name |
| Mother's Surname | Murray | | Mother's Residence |
| Mother's Nationality | American | New York | Mother's Birth Place |
| Mother's Age | 35 | 1 | Number of Child This Mother |
| Medical Attendant's Name | Lewis Schooler | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | Lewis Schooler | Nevada IA | Certificate Signer's Address |
| Returned by Name | Lewis Schooler | | |