| Certificate Number | 89 | | Date Issued |
| Child Given Name | |
Ryan | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 06 Dec 1880 |
Union Twp Story Co IA | Place of Birth |
| Father's Given Name | David T. |
Ryan | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Connecticut | 31 | Father's Age |
| Mother's Given Name | Clementine | Knight | Mother's Maiden Name |
| Mother's Surname | Ryan | Union Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Cambridge Story Co IA | Mother's Birth Place |
| Mother's Age | 30 | 3 | Number of Child This Mother |
| Medical Attendant's Name | D.D. Hays | Cambridge IA | Medical Attendant's Address |
| Certificate Signer's Name | D.D. Hays | Cambridge IA | Certificate Signer's Address |
| Returned by Name | D.D. Hays | | |