| Certificate Number | 68 | | Date Issued |
| Child Given Name | Aron |
Scott | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 31 Aug 1888 |
Union Twp Story Co IA | Place of Birth |
| Father's Given Name | Dick |
Scott | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Scotland | 33 | Father's Age |
| Mother's Given Name | Rosette | Cassady | Mother's Maiden Name |
| Mother's Surname | | Union Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 19 | 1 | Number of Child This Mother |
| Medical Attendant's Name | Mrs. Casssady | Cambridge IA | Medical Attendant's Address |