Certificate Number | 435 | | Date Issued |
Child Given Name | |
Thomas | Child Surname |
Child Sex | Female |
W | Child Race |
Date of Birth | 20 Sep 1886 |
Nevada Twp Story Co IA | Place of Birth |
Father's Given Name | Abner H. |
Thomas | Father's Surname |
Father's Occupation | Farmer | | Father's Nationality |
Father's Birth Place | Indiana | 36 | Father's Age |
Mother's Given Name | Mattie | Vinell | Mother's Maiden Name |
Mother's Surname | Thomas | Nevada Twp Story Co IA | Mother's Residence |
Mother's Nationality | | Iowa | Mother's Birth Place |
Mother's Age | 25 | 3 | Number of Child This Mother |
Medical Attendant's Name | E.H. Monk | Nevada IA | Medical Attendant's Address |
Certificate Signer's Name | E.H. Monk | Nevada IA | Certificate Signer's Address |
Returned by Name | E.H. Monk | | |