| Certificate Number | 59 | | Date Issued |
| Child Given Name | |
McKinney | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 25 Jan 1885 |
Story Co IA | Place of Birth |
| Father's Given Name | S.W. |
McKinney | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Illinois | 25 | Father's Age |
| Mother's Given Name | Ida V. | White | Mother's Maiden Name |
| Mother's Surname | McKinney | Union Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 25 | 1 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |
| Certificate Signer's Name | J.M. Brown | Cambridge IA | Certificate Signer's Address |
| Returned by Name | J.M. Brown | | |