Certificate Number | 157 | | Date Issued |
Child Given Name | Ella |
McLain | Child Surname |
Child Sex | Female |
W | Child Race |
Date of Birth | 15 Mar 1889 |
Colo Story Co IA | Place of Birth |
Father's Given Name | John |
McLain | Father's Surname |
Father's Occupation | Barber | | Father's Nationality |
Father's Birth Place | Illinois | 31 | Father's Age |
Mother's Given Name | Irene | Page | Mother's Maiden Name |
Mother's Surname | | Colo Story Co IA | Mother's Residence |
Mother's Nationality | | Ohio | Mother's Birth Place |
Mother's Age | 32 | 4 | Number of Child This Mother |
Medical Attendant's Name | J.I. Hostetter | Colo IA | Medical Attendant's Address |