| Certificate Number | 596 | | Date Issued |
| Child Given Name | |
Shenkle | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 08 Aug 1887 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | John W. |
Shenkle | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Indiana | 38 | Father's Age |
| Mother's Given Name | Emma | Richmond | Mother's Maiden Name |
| Mother's Surname | Shenkle | Collins Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | New York | Mother's Birth Place |
| Mother's Age | 36 | 6 | Number of Child This Mother |
| Medical Attendant's Name | A.P. Edgar | Collins IA | Medical Attendant's Address |