Certificate Number | 1044 | | Date Issued |
Child Given Name | Willah Belle |
Miller | Child Surname |
Child Sex | Female |
W | Child Race |
Date of Birth | 07 Jun 1884 |
Ames Story Co IA | Place of Birth |
Father's Given Name | Orra S. |
Miller | Father's Surname |
Father's Occupation | Barber | American | Father's Nationality |
Father's Birth Place | Polk City Polk Co IA | 25 | Father's Age |
Mother's Given Name | Nannie | Ginn | Mother's Maiden Name |
Mother's Surname | Miller | Ames Story Co IA | Mother's Residence |
Mother's Nationality | American | Pleasant Grove Looper Co Mi | Mother's Birth Place |
Mother's Age | 20 | 2 | Number of Child This Mother |
Medical Attendant's Name | Kate, Mrs. Quick | Ames IA | Medical Attendant's Address |
Certificate Signer's Name | Kate, Mrs. Quick | Ames IA | Certificate Signer's Address |
Returned by Name | Kate, Mrs. Quick | | |