| Certificate Number | 198 | | Date Issued |
| Child Given Name | Kate L. |
Oswald | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 09 Sep 1885 |
Lafayette Twp Story Co IA | Place of Birth |
| Father's Given Name | John |
Oswald | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Germany | 42 | Father's Age |
| Mother's Given Name | Amelia | Birkenholy | Mother's Maiden Name |
| Mother's Surname | Oswald | Lafayette Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Germany | Mother's Birth Place |
| Mother's Age | 34 | 5 | Number of Child This Mother |
| Medical Attendant's Name | E.B. Plumb M.D. | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | E.B. Plumb M.D. | Ames IA | Certificate Signer's Address |
| Returned by Name | E.B. Plumb M.D. | | |