| Child Given Name | Charles Albert |
Brown | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 28 Nov 1889 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | Morgan Benjamin |
Brown | Father's Surname |
| Father's Occupation | | American | Father's Nationality |
| Father's Birth Place | Rochelle IL | | Father's Age |
| Mother's Given Name | Ellen Aroith | Chase | Mother's Maiden Name |
| Mother's Surname | Brown | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | American | Lena IL | Mother's Birth Place |
| Mother's Age | | 4 | Number of Child This Mother |
| Medical Attendant's Name | Dr. Bartlet | | Medical Attendant's Address |