| Certificate Number | 137 | | Date Issued |
| Child Given Name | |
Okland | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 17 Mar 1889 |
Lafayette Twp Story Co IA | Place of Birth |
| Father's Given Name | M.J. |
Okland | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Norway | | Father's Age |
| Mother's Given Name | Marie | Johnson | Mother's Maiden Name |
| Mother's Surname | | Story Co IA | Mother's Residence |
| Mother's Nationality | | Norway | Mother's Birth Place |
| Medical Attendant's Name | Mrs. Peterson | Story City IA | Medical Attendant's Address |