| Certificate Number | 66 | | Date Issued |
| Child Given Name | Lena Johanna |
Seske | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 02 Dec 1888 |
Union Twp Story Co IA | Place of Birth |
| Father's Given Name | F. John |
Seske | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Stevens Co IL | 29 | Father's Age |
| Mother's Given Name | Anna | Enge | Mother's Maiden Name |
| Mother's Surname | | Union Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Norway | Mother's Birth Place |
| Mother's Age | 26 | 1 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |