| Certificate Number | 44 | | Date Issued |
| Child Given Name | |
Noble | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 21 Nov 1887 |
Pleasant Grove IA | Place of Birth |
| Father's Given Name | Johnson |
Noble | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Indiana | 26 | Father's Age |
| Mother's Given Name | Laura E. | Shattuck | Mother's Maiden Name |
| Mother's Surname | Noble | Pleasant Grove IA | Mother's Residence |
| Mother's Nationality | | Illinois | Mother's Birth Place |
| Mother's Age | 26 | 1 | Number of Child This Mother |
| Medical Attendant's Name | E.B. Plumb | Ames IA | Medical Attendant's Address |