| Certificate Number | 793 | | Date Issued |
| Child Given Name | Margaret Coutney |
McArtor | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 15 Oct 1883 |
Elwell Story Co IA | Place of Birth |
| Father's Given Name | Colin Ball |
McArtor | Father's Surname |
| Father's Occupation | Carpenter | American | Father's Nationality |
| Father's Birth Place | Virginia | 33 | Father's Age |
| Mother's Given Name | Etta S. | Sherman | Mother's Maiden Name |
| Mother's Surname | McArtor | Elwell Story Co IA | Mother's Residence |
| Mother's Nationality | American | Illinois | Mother's Birth Place |
| Mother's Age | 26 | 1 | Number of Child This Mother |
| Medical Attendant's Name | D.D. Hayes | Cambridge IA | Medical Attendant's Address |
| Certificate Signer's Name | D.D. Hayes | Cambridge IA | Certificate Signer's Address |
| Returned by Name | D.D. Hayes | | |