| Certificate Number | 234 | | Date Issued |
| Child Given Name | Floyd B. |
Campbell | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 10 Oct 1887 |
Milford Twp Story Co IA | Place of Birth |
| Father's Given Name | G.A. |
Campbell | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Iowa | 29 | Father's Age |
| Mother's Given Name | Ada | Hall | Mother's Maiden Name |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 31 | 4 | Number of Child This Mother |
| Medical Attendant's Name | Geo. Stitzell | Nevada IA | Medical Attendant's Address |