| Certificate Number | 426 | | Date Issued |
| Child Given Name | Ruby Estella |
Young | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 03 Nov 1886 |
Milford Twp Story Co IA | Place of Birth |
| Father's Given Name | George |
Young | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Iowa | 30 | Father's Age |
| Mother's Given Name | Aminda J. | Sowers | Mother's Maiden Name |
| Mother's Surname | Young | | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 26 | 2 | Number of Child This Mother |
| Medical Attendant's Name | G. Stitzell | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | G. Stitzell | Nevada IA | Certificate Signer's Address |
| Returned by Name | G. Stitzell | | |