| Certificate Number | 686 | | Date Issued |
| Child Given Name | |
Alderman | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 19 Jun 1883 |
| Place of Birth |
| Father's Given Name | Silas P. |
Alderman | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Iowa | 34 | Father's Age |
| Mother's Given Name | M.J. | Elison | Mother's Maiden Name |
| Mother's Surname | Alderman | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 27 | 3 | Number of Child This Mother |
| Medical Attendant's Name | E.H. Munk | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | E.H. Munk | Nevada IA | Certificate Signer's Address |
| Returned by Name | E.H. Munk | | |