Certificate Number | 596 | | Date Issued |
Child Given Name | Ole Martin |
Nerness | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 15 Feb 1883 |
Palestine Twp Story Co IA | Place of Birth |
Father's Given Name | Tomas O. |
Nerness | Father's Surname |
Father's Occupation | Laborer | American | Father's Nationality |
Father's Birth Place | Iowa | 24 | Father's Age |
Mother's Given Name | Martha C. | Sheldall | Mother's Maiden Name |
Mother's Surname | Nernes | Palestine Twp Story Co IA | Mother's Residence |
Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
Mother's Age | 25 | 1 | Number of Child This Mother |
Medical Attendant's Name | D.D. Hayes | Cambridge IA | Medical Attendant's Address |
Certificate Signer's Name | D.D. Hayes | Cambridge IA | Certificate Signer's Address |
Returned by Name | D.D. Hayes | | |