| Certificate Number | 371 | | Date Issued |
| Child Given Name | Arthur Peter |
Bunce | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 22 Aug 1886 |
Lafayette Twp Story Co IA | Place of Birth |
| Father's Given Name | David King |
Bunce | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Illinois | 42 | Father's Age |
| Mother's Given Name | Elizabeth | Linrode | Mother's Maiden Name |
| Mother's Surname | Bunce | Story County IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 38 | 7 | Number of Child This Mother |
| Medical Attendant's Name | B.F. Allen | Story City IA | Medical Attendant's Address |
| Certificate Signer's Name | B.F. Allen | Story City IA | Certificate Signer's Address |
| Returned by Name | B.F. Allen | | |