Certificate Number | 871 | | Date Issued |
Child Given Name | Floyd |
Purkhiser | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 08 Feb 1884 |
Nevada Story Co IA | Place of Birth |
Father's Given Name | W.A. |
Purkhiser | Father's Surname |
Father's Occupation | Laborer | American | Father's Nationality |
Father's Birth Place | Ohio | 28 | Father's Age |
Mother's Given Name | Frances A. | Morgan | Mother's Maiden Name |
Mother's Surname | Purkhiser | Nevada Story Co IA | Mother's Residence |
Mother's Nationality | American | Iowa | Mother's Birth Place |
Mother's Age | 21 | 1 | Number of Child This Mother |
Medical Attendant's Name | Geo Stitzell | Nevada IA | Medical Attendant's Address |
Certificate Signer's Name | Geo Stitzell | Nevada IA | Certificate Signer's Address |
Returned by Name | Geo Stitzell | | |