| Child Given Name | Gertrude |
Bracken | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 07 May 1875 |
Story City Story Co IA | Place of Birth |
| Father's Given Name | Perry |
Bracken | Father's Surname |
| Father's Occupation | Farming | American | Father's Nationality |
| Father's Birth Place | Iowa | | Father's Age |
| Mother's Given Name | Elizabeth | Yarrington | Mother's Maiden Name |
| Mother's Surname | Bracken | | Mother's Residence |
| Mother's Nationality | American | Pennsylvania | Mother's Birth Place |
| Mother's Age | | 3 | Number of Child This Mother |
| Medical Attendant's Name | Dr. Allen | | Medical Attendant's Address |
| Certificate Signer's Name | Lettie, Mrs. Gable | Hartley IA | Certificate Signer's Address |