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| From Birth Record Volume 3 1897-1908 Page 160a |
| Child Given Name | Clarence Johan | Male | Child Surname |
| Child Sex | Male | Child Race | |
| Date of Birth | 21 Jun 1899 | Warren Twp | Place of Birth |
| Father's Given Name | Lars P | Male | Father's Surname |
| Mother's Given Name | Engeborg | Ostrem | Mother's Maiden Name |
| Transcription Comment... |
| Notation on register that name and date amended by marriage record and drivers license on 06 Jul 1972. |
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