| Certificate Number | 424 | | Date Issued |
| Child Given Name | Rogers Frances |
O'Donnell | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 29 Oct 1886 |
New Albany Twp Story Co IA | Place of Birth |
| Father's Given Name | James |
O'Donnell | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | England | 31 | Father's Age |
| Mother's Given Name | Katie A. | McCoy | Mother's Maiden Name |
| Mother's Surname | O'Donnell | | Mother's Residence |
| Mother's Nationality | | Virginia | Mother's Birth Place |
| Mother's Age | 28 | 1 | Number of Child This Mother |
| Medical Attendant's Name | George Stitzell | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | George Stitzell | Nevada IA | Certificate Signer's Address |
| Returned by Name | George Stitzell | | |