| Certificate Number | 24 | | Date Issued |
| Child Given Name | Earl |
Bowen | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 06 Oct 1889 |
Maxwell Story Co IA | Place of Birth |
| Father's Given Name | Aaron |
Bowen | Father's Surname |
| Father's Occupation | Blacksmith | | Father's Nationality |
| Father's Birth Place | Indiana | 48 | Father's Age |
| Mother's Given Name | Lizzie | Bernard | Mother's Maiden Name |
| Mother's Surname | | Maxwell Story Co IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 27 | 1 | Number of Child This Mother |
| Medical Attendant's Name | P. Joor | Maxwell Ia | Medical Attendant's Address |