| Certificate Number | 127 | | Date Issued |
| Child Given Name | Chas. O. |
Boyington | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 04 Sep 1887 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | E.R. |
Boyington | Father's Surname |
| Father's Occupation | Commercial Traveler | | Father's Nationality |
| Father's Birth Place | Wisconson | 35 | Father's Age |
| Mother's Given Name | Mary | | Mother's Maiden Name |
| Mother's Surname | Boyinton | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Illinois | Mother's Birth Place |
| Mother's Age | 33 | 2 | Number of Child This Mother |
| Medical Attendant's Name | D.S. Fairchild | Ames IA | Medical Attendant's Address |