| Certificate Number | 244 | | Date Issued |
| Child Given Name | Maud |
Wilkie | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 14 Sep 1881 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | George |
Wilkie | Father's Surname |
| Father's Occupation | Day Laborer | American | Father's Nationality |
| Father's Birth Place | Michigan | 30 | Father's Age |
| Mother's Given Name | Mary | Shaw | Mother's Maiden Name |
| Mother's Surname | Wilkie | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | American | Rich Co MI | Mother's Birth Place |
| Mother's Age | 21 | 3 | Number of Child This Mother |
| Medical Attendant's Name | L.C., Mrs. Butt | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | L.C., Mrs. Butt | Nevada IA | Certificate Signer's Address |
| Returned by Name | L.C., Mrs. Butt | | |