| Certificate Number | 73 | | Date Issued |
| Child Given Name | Jennie D. |
Tennant | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 15 Oct 1888 |
Iowa Center Story Co IA | Place of Birth |
| Father's Given Name | Lafayette |
Tennant | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Wisconson | 30 | Father's Age |
| Mother's Given Name | Nancy | See | Mother's Maiden Name |
| Mother's Surname | | Iowa Center Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 23 | 2 | Number of Child This Mother |
| Medical Attendant's Name | F. Thompson | Iowa Center IA | Medical Attendant's Address |