| Certificate Number | 232 | | Date Issued |
| Child Given Name | Liza |
Sloan | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 25 Dec 1885 |
Lincoln Twp Story Co IA | Place of Birth |
| Father's Given Name | John |
Sloan | Father's Surname |
| Father's Occupation | Farmer | Scott | Father's Nationality |
| Father's Birth Place | Scotland | | Father's Age |
| Mother's Given Name | Rebecca | Blayney | Mother's Maiden Name |
| Mother's Surname | Sloan | Washington Twp Marshall Co IA | Mother's Residence |
| Mother's Nationality | | Ireland | Mother's Birth Place |
| Mother's Age | | 7 | Number of Child This Mother |
| Medical Attendant's Name | F.S. Newton | Zearing IA | Medical Attendant's Address |
| Certificate Signer's Name | F.S. Newton | Zearing IA | Certificate Signer's Address |
| Returned by Name | F.S. Newton | | |