| Child Given Name | Dale |
Yeaton | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 23 Jan 1890 |
Maxwell Story Co IA | Place of Birth |
| Father's Given Name | Harvey W. |
Yeaton | Father's Surname |
| Father's Occupation | Tinner | | Father's Nationality |
| Father's Birth Place | Maine | 32 | Father's Age |
| Mother's Given Name | Lizzie | Bently | Mother's Maiden Name |
| Mother's Surname | | Maxwell Story Co IA | Mother's Residence |
| Mother's Nationality | | Story Co IA | Mother's Birth Place |
| Mother's Age | 24 | 2 | Number of Child This Mother |
| Medical Attendant's Name | E.C. Scott | Maxwell IA | Medical Attendant's Address |