Certificate Number | 238 | | Date Issued |
Child Given Name | Ralph Stuart |
Anderson | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 13 Jan 1886 |
| Place of Birth |
Father's Given Name | Robt. S. |
Anderson | Father's Surname |
Father's Occupation | Farmer | | Father's Nationality |
Father's Birth Place | Pennsylvania | 50 | Father's Age |
Mother's Given Name | Annie | Massingham | Mother's Maiden Name |
Mother's Surname | Anderson | | Mother's Residence |
Mother's Nationality | | Virginia | Mother's Birth Place |
Mother's Age | 37 | 7 | Number of Child This Mother |
Medical Attendant's Name | A.W. Brooks | Zearing IA | Medical Attendant's Address |
Certificate Signer's Name | A.W. Brooks | Zearing IA | Certificate Signer's Address |
Returned by Name | A.W. Brooks | | |