| Certificate Number | 223 | | Date Issued |
| Child Given Name | |
Bright | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 29 Jul 1890 |
Milford Twp Story Co IA | Place of Birth |
| Father's Given Name | Harry W. |
Bright | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Indiana | 24 | Father's Age |
| Mother's Given Name | Edith | Hunchley | Mother's Maiden Name |
| Mother's Surname | | Milford Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Wisconson | Mother's Birth Place |
| Mother's Age | 24 | 1 | Number of Child This Mother |
| Medical Attendant's Name | E.H. Munk | Nevada IA | Medical Attendant's Address |