| Certificate Number | 38 | | Date Issued |
| Child Given Name | Stella S. |
Ballard | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 21 Nov 1888 |
Grant Twp Story Co IA | Place of Birth |
| Father's Given Name | J.H. |
Ballard | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Iowa | 38 | Father's Age |
| Mother's Given Name | Malinda J. | Stratton | Mother's Maiden Name |
| Mother's Surname | | Grant Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Indiana | Mother's Birth Place |
| Mother's Age | 40 | 6 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |