| Certificate Number | 484 | | Date Issued |
| Child Given Name | |
Stanton | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 19 Jan 1887 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | E.W. |
Stanton | Father's Surname |
| Father's Occupation | Prof. | | Father's Nationality |
| Father's Birth Place | Pennsylvania | 36 | Father's Age |
| Mother's Given Name | Margaret | McDonald | Mother's Maiden Name |
| Mother's Surname | Stanton | | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 41 | 4 | Number of Child This Mother |
| Medical Attendant's Name | E.B. Plumb | Ames IA | Medical Attendant's Address |