Certificate Number | 100 | | Date Issued |
Child Given Name | Mabel Josephine |
Taylor | Child Surname |
Child Sex | Female |
W | Child Race |
Date of Birth | 20 Apr 1885 |
Nevada Story Co IA | Place of Birth |
Father's Given Name | James W.L. |
Taylor | Father's Surname |
Father's Occupation | Farmer | American | Father's Nationality |
Father's Birth Place | Indiana | 26 | Father's Age |
Mother's Given Name | Samantha | Carr | Mother's Maiden Name |
Mother's Surname | Taylor | Nevada Story Co IA | Mother's Residence |
Mother's Nationality | American | Iowa | Mother's Birth Place |
Mother's Age | 21 | 1 | Number of Child This Mother |
Medical Attendant's Name | Jno. I. Hostetter | Colo IA | Medical Attendant's Address |
Certificate Signer's Name | Jno. I. Hostetter | Colo IA | Certificate Signer's Address |
Returned by Name | Jno. I. Hostetter | | |