| Certificate Number | 15 | | Date Issued |
| Child Given Name | |
Runyon | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 15 Sep 1887 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | Joseph |
Runyon | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Ohio | 44 | Father's Age |
| Mother's Given Name | Celia | Deter | Mother's Maiden Name |
| Mother's Surname | Runyon | Collins Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 40 | 11 | Number of Child This Mother |
| Medical Attendant's Name | A.P. Edgar | Collins IA | Medical Attendant's Address |