| Certificate Number | 555 | | Date Issued |
| Child Given Name | Martin |
Thorger | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 02 Apr 1887 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Abraham |
Thorgerson | Father's Surname |
| Father's Occupation | Rail Roader | Norwegian | Father's Nationality |
| Father's Birth Place | Norway | 32 | Father's Age |
| Mother's Given Name | Serine | Olson | Mother's Maiden Name |
| Mother's Surname | Thorgerson | | Mother's Residence |
| Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
| Mother's Age | 27 | 11 | Number of Child This Mother |
| Returned by Name | A.S. Aplin | | |