| Certificate Number | 71 | | Date Issued |
| Child Given Name | B.T. |
Quinsland | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 15 Nov 1880 |
Palestine Twp Story Co IA | Place of Birth |
| Father's Given Name | Thomas |
Quinsland | Father's Surname |
| Father's Occupation | Farmer | Norwegian | Father's Nationality |
| Father's Birth Place | Norway | 33 | Father's Age |
| Mother's Given Name | Helen | Walker | Mother's Maiden Name |
| Mother's Surname | Quinsland | Palestine Twp Story Co IA | Mother's Residence |
| Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
| Mother's Age | 20 | 1 | Number of Child This Mother |
| Returned by Name | Thomas Quinsland | | |