| Certificate Number | 215 | | Date Issued |
| Child Given Name | |
Sodestrum | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 31 Aug 1890 |
Washington Twp Story Co IA | Place of Birth |
| Father's Given Name | Peter |
Sodestrum | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Sweden | 27 | Father's Age |
| Mother's Given Name | Eliz. | Sodestrum | Mother's Maiden Name |
| Mother's Surname | | Washington Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Story Co IA | Mother's Birth Place |
| Mother's Age | 23 | 3 | Number of Child This Mother |
| Medical Attendant's Name | H.M. Templeton | Ames IA | Medical Attendant's Address |