| Certificate Number | 40 | | Date Issued |
| Child Given Name | Lena E. |
Presnall | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 27 Oct 1888 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | John W. |
Presnall | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Indiana | 42 | Father's Age |
| Mother's Given Name | Martha | Harrison | Mother's Maiden Name |
| Mother's Surname | | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | | Indiana | Mother's Birth Place |
| Mother's Age | 44 | 13 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |