| Certificate Number | 433 | | Date Issued |
| Child Given Name | Harry Edson |
Stowe | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 14 Jun 1882 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Charles H. |
Stowe | Father's Surname |
| Father's Occupation | Carpenter | American | Father's Nationality |
| Father's Birth Place | Ohio | 45 | Father's Age |
| Mother's Given Name | Laura E. | Hubbard | Mother's Maiden Name |
| Mother's Surname | Stowe | Cambridge Story IA | Mother's Residence |
| Mother's Nationality | American | New York | Mother's Birth Place |
| Mother's Age | 38 | 7 | Number of Child This Mother |
| Medical Attendant's Name | D.D. Hayes M.D. | Cambridge IA | Medical Attendant's Address |
| Certificate Signer's Name | D.D. Hayes M.D. | Cambridge IA | Certificate Signer's Address |
| Returned by Name | D.D. Hayes M.D. | | |