| Certificate Number | 251 | | Date Issued |
| Child Given Name | Tesse Elizabeth |
Ryan | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 05 Sep 1889 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Dan |
Ryan | Father's Surname |
| Father's Occupation | Teamster | | Father's Nationality |
| Father's Birth Place | Connecticut | 42 | Father's Age |
| Mother's Given Name | Clementine | Knight | Mother's Maiden Name |
| Mother's Surname | | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 29 | 7 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |