| Certificate Number | 760 | | Date Issued |
| Child Given Name | |
McNaughton | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 15 Mar 1883 |
Zenorville Story Co IA | Place of Birth |
| Father's Given Name | Geo |
McNaughton | Father's Surname |
| Father's Occupation | Miner | | Father's Nationality |
| Father's Birth Place | | 24 | Father's Age |
| Mother's Given Name | Alma | Lathrum | Mother's Maiden Name |
| Mother's Surname | McNaughton | Zenorville Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 20 | 1 | Number of Child This Mother |
| Medical Attendant's Name | C.A. Beverly | Ames IA | Medical Attendant's Address |