| Certificate Number | 23 | | Date Issued |
| Child Given Name | |
McCowin | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 01 Dec 1884 |
Iowa Center Story Co IA | Place of Birth |
| Father's Given Name | Edwin H. |
McCowen | Father's Surname |
| Father's Occupation | Everything | American | Father's Nationality |
| Father's Birth Place | Iowa | 23 | Father's Age |
| Mother's Given Name | Ida A. | Boyd | Mother's Maiden Name |
| Mother's Surname | | Iowa Center Story Co IA | Mother's Residence |
| Mother's Nationality | | Grant City Sac Co IA | Mother's Birth Place |
| Mother's Age | 17 | 1 | Number of Child This Mother |
| Medical Attendant's Name | B.O., Mrs. Higley | Iowa Center IA | Medical Attendant's Address |