| Certificate Number | 183 | | Date Issued |
| Child Given Name | Eva |
Reynolds | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 18 Jun 1890 |
New Albany Twp Story Co IA | Place of Birth |
| Father's Given Name | John |
Reynolds | Father's Surname |
| Father's Occupation | Farmer | I | Father's Nationality |
| Father's Birth Place | Ireland | 56 | Father's Age |
| Mother's Given Name | | Croaker | Mother's Maiden Name |
| Mother's Surname | | New Albany Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Ireland | Mother's Birth Place |
| Mother's Age | 43 | 10 | Number of Child This Mother |
| Medical Attendant's Name | J.I. Hostetter | Colo IA | Medical Attendant's Address |