| Certificate Number | 226 | | Date Issued |
| Child Given Name | Clarence |
Compton | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 14 Dec 1885 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | Hugh |
Compton | Father's Surname |
| Father's Occupation | Musician | | Father's Nationality |
| Father's Birth Place | Chalfield MO | 28 | Father's Age |
| Mother's Given Name | Ora M. | Black | Mother's Maiden Name |
| Mother's Surname | Compton | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Lee Co IL | Mother's Birth Place |
| Mother's Age | 24 | 3 | Number of Child This Mother |
| Medical Attendant's Name | J.L., Mrs. Bartlett | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | J.L., Mrs. Bartlett | Ames IA | Certificate Signer's Address |
| Returned by Name | J.L., Mrs. Bartlett | | |