| Child Given Name | Celia Cedsin |
Peterson | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 08 Feb 1890 |
Washington Twp Story Co IA | Place of Birth |
| Father's Given Name | Paul |
Peterson | Father's Surname |
| Father's Occupation | Laborer | Scandanvian | Father's Nationality |
| Father's Birth Place | Denmark | | Father's Age |
| Mother's Given Name | Isabell | Bonebrake | Mother's Maiden Name |
| Mother's Surname | Peterson | Washington Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Bloomfield IA | Mother's Birth Place |
| Mother's Age | | 3 | Number of Child This Mother |
| Medical Attendant's Name | Dr. Beverly | | Medical Attendant's Address |
| Certificate Signer's Name | Caroline Coe | Ames IA | Certificate Signer's Address |