| Certificate Number | 32 | | Date Issued |
| Child Given Name | Willie Milton |
Sheldon | Child Surname |
| Child Sex | Male |
A | Child Race |
| Date of Birth | 18 Jul 1880 |
Iowa Center Story Co IA | Place of Birth |
| Father's Given Name | Dwight DeLa D. |
Sheldon | Father's Surname |
| Father's Occupation | Farmer & Teaching | Iowa | Father's Nationality |
| Father's Birth Place | Knoxville IA | 25 | Father's Age |
| Mother's Given Name | Henrietta Alma | Fish | Mother's Maiden Name |
| Mother's Surname | Sheldon | Iowa Center Story Co IA | Mother's Residence |
| Mother's Nationality | American | Eddyville IA | Mother's Birth Place |
| Mother's Age | 25 | 2 | Number of Child This Mother |
| Medical Attendant's Name | M.D. Sheldon | Iowa Center IA | Medical Attendant's Address |
| Certificate Signer's Name | M.D. Sheldon | Iowa Center IA | Certificate Signer's Address |
| Returned by Name | M.D. Sheldon | | |