| Certificate Number | 209 | | Date Issued |
| Child Given Name | Louie E. |
Stoops | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 17 Sep 1890 |
Franklin Twp Story Co IA | Place of Birth |
| Father's Given Name | I.R. |
Stoops | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Indiana | 49 | Father's Age |
| Mother's Given Name | Effie A. | Davis | Mother's Maiden Name |
| Mother's Surname | | Franklin Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 34 | 5 | Number of Child This Mother |
| Medical Attendant's Name | Albert Richmond | Ames IA | Medical Attendant's Address |