| Certificate Number | 112 | | Date Issued |
| Child Given Name | Samuel M. |
Switzer | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 12 Apr 1888 |
Grant Twp Story Co IA | Place of Birth |
| Father's Given Name | Wm. I. |
Switzer | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Grant Twp Story Co IA | 26 | Father's Age |
| Mother's Given Name | Mary | Johnston | Mother's Maiden Name |
| Mother's Nationality | | England | Mother's Birth Place |
| Mother's Age | 26 | 2 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |