Certificate Number | 1060 | | Date Issued |
Child Given Name | Margaret |
Peterson | Child Surname |
Child Sex | Female |
W | Child Race |
Date of Birth | 08 Jul 1884 |
Nevada Story Co IA | Place of Birth |
Father's Given Name | John |
Peterson | Father's Surname |
Father's Occupation | Laborer | | Father's Nationality |
Father's Birth Place | Denmark | 28 | Father's Age |
Mother's Given Name | Sena | Paulson | Mother's Maiden Name |
Mother's Surname | Petersen | Nevada Story Co IA | Mother's Residence |
Mother's Nationality | | Denmark | Mother's Birth Place |
Mother's Age | 23 | 2 | 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 | | |