| Certificate Number | 338 | | Date Issued |
| Child Given Name | James Allen |
Raxton | Child Surname |
| Child Sex | Male |
| Child Race |
| Date of Birth | 19 Dec 1881 |
Warren Twp Story Co IA | Place of Birth |
| Father's Given Name | Adam Hill |
Raxton | Father's Surname |
| Father's Occupation | Farmer | Scoth | Father's Nationality |
| Father's Birth Place | Scotland | 31 | Father's Age |
| Mother's Given Name | Margaret | Wallace | Mother's Maiden Name |
| Mother's Surname | Raxton | | Mother's Residence |
| Mother's Nationality | Scotch | Scotland | Mother's Birth Place |
| Mother's Age | | 4 | Number of Child This Mother |
| Medical Attendant's Name | E.H. Monk M.D. | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | E.H. Monk M.D. | Nevada IA | Certificate Signer's Address |
| Returned by Name | E.H. Monk M.D. | | |