| Certificate Number | 870 | | Date Issued |
| Child Given Name | Anna Olive |
Apland | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 11 Feb 1884 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Knute |
Apland | Father's Surname |
| Father's Occupation | Merchant | Norwegian | Father's Nationality |
| Father's Birth Place | Iowa | 25 | Father's Age |
| Mother's Given Name | Tomine | Erickson | Mother's Maiden Name |
| Mother's Surname | Apland | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
| Mother's Age | 19 | 1 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Bynon? | Cambridge IA | Medical Attendant's Address |
| Certificate Signer's Name | J.M. Bynon? | Cambridge IA | Certificate Signer's Address |
| Returned by Name | J.M. Bynon? | | |