| Certificate Number | 246 | | Date Issued |
| Child Given Name | Isaac |
Mynear | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 10 Feb 1886 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | M.P. |
Mynear | Father's Surname |
| Father's Birth Place | Indiana | 33 | Father's Age |
| Mother's Given Name | Sarah | McQuiston | Mother's Maiden Name |
| Mother's Surname | Mynear | Collins Story Co IA | Mother's Residence |
| Mother's Nationality | | Story Co IA | Mother's Birth Place |
| Mother's Age | | 2 | Number of Child This Mother |
| Medical Attendant's Name | Marion Mullen | | Medical Attendant's Address |