| Child Given Name | Bertha May |
Spratt | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 07 May 1883 |
Colo Story Co IA | Place of Birth |
| Father's Given Name | William George |
Spratt | Father's Surname |
| Father's Occupation | Clerk | American | Father's Nationality |
| Father's Birth Place | New York | 25 | Father's Age |
| Mother's Given Name | Rose Ann | Brouhard | Mother's Maiden Name |
| Mother's Surname | Spratt | | Mother's Residence |
| Mother's Nationality | American | Indiana | Mother's Birth Place |
| Mother's Age | 21 | | Number of Child This Mother |
| Certificate Signer's Name | Rosa, Mrs. Spratt | | Certificate Signer's Address |