Certificate Number | 17 | | Date Issued |
Child Given Name | |
Weir | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 09 Oct 1888 |
Sherman Twp Story Co IA | Place of Birth |
Father's Given Name | Robt. |
Weir | Father's Surname |
Father's Occupation | Farmer | | Father's Nationality |
Father's Birth Place | Canada | 37 | Father's Age |
Mother's Given Name | Emma | Bishop | Mother's Maiden Name |
Mother's Surname | | Sherman Twp Story Co IA | Mother's Residence |
Mother's Nationality | | Canada | Mother's Birth Place |
Mother's Age | 32 | 3 | Number of Child This Mother |
Medical Attendant's Name | J.I. Hostetter | Colo IA | Medical Attendant's Address |