| Certificate Number | 900 | | Date Issued |
| Child Given Name | Henry Neltson |
Trauger | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 29 Feb 1884 |
Collins Story Co IA | Place of Birth |
| Father's Given Name | Samuel J. |
Trauger | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Pennsylvania | 28 | Father's Age |
| Mother's Given Name | Charlotte A. | Snook | Mother's Maiden Name |
| Mother's Surname | Trauger | Collins Story Co IA | Mother's Residence |
| Mother's Nationality | American | Ohio | Mother's Birth Place |
| Mother's Age | 29 | 4 | Number of Child This Mother |
| Medical Attendant's Name | A.P. Eilgier | Clyde IA | Medical Attendant's Address |
| Certificate Signer's Name | A.P. Eilgier | Clyde IA | Certificate Signer's Address |
| Returned by Name | A.P. Eilgier | | |