| Certificate Number | 89 | | Date Issued |
| Child Given Name | |
Chandler | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 19 Jan 1888 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | E.G. |
Chandler | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Maine | 60 | Father's Age |
| Mother's Given Name | Medora | Chandler | Mother's Maiden Name |
| Mother's Surname | Chandler | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | | Illinois | Mother's Birth Place |
| Mother's Age | 31 | 1 | Number of Child This Mother |
| Medical Attendant's Name | A.S. Aplin | Cambridge IA | Medical Attendant's Address |