| Certificate Number | 607 | | Date Issued |
| Child Given Name | |
Wentzell | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 24 May 1887 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Adam |
Wentzel | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Pennsylvania | 39 | Father's Age |
| Mother's Given Name | Julia | Wentzel | Mother's Maiden Name |
| Mother's Surname | | Lopshire | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 36 | 7 | Number of Child This Mother |
| Medical Attendant's Name | J.I. Hostetter | Colo IA | Medical Attendant's Address |