| Child Given Name | Ruth |
Corvan | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 18 May 1879 |
near Colo Story Co IA | Place of Birth |
| Father's Given Name | Robert |
Corvan | Father's Surname |
| Father's Occupation | Shoemaker | Irish | Father's Nationality |
| Father's Birth Place | Ireland | 35 | Father's Age |
| Mother's Given Name | Ruth | Wilson | Mother's Maiden Name |
| Mother's Surname | Corvan | | Mother's Residence |
| Mother's Nationality | Irish | Ireland | Mother's Birth Place |
| Mother's Age | 32 | 6 | Number of Child This Mother |
| Medical Attendant's Name | J.I. Dr. Hostetter | | Medical Attendant's Address |
| Certificate Signer's Name | Jennie Dunahoo | Maxwell Story Co IA | Certificate Signer's Address |
| Returned by Name | 'Sister' | | |