| Certificate Number | 6 | | Date Issued |
| Child Given Name | Guy |
Duntz | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 01 Jul 1880 |
Franklin Twp Story Co IA | Place of Birth |
| Father's Given Name | Charles |
Duntz | Father's Surname |
| Father's Occupation | Farmer | German | Father's Nationality |
| Father's Birth Place | New York | 23 | Father's Age |
| Mother's Given Name | Anna | Hunter | Mother's Maiden Name |
| Mother's Surname | Duntz | Franklin Twp Story Co IA | Mother's Residence |
| Mother's Nationality | Not Known | Ohio | Mother's Birth Place |
| Mother's Age | 30 | 1 | Number of Child This Mother |
| Medical Attendant's Name | G.A. Meridith | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | G.A. Meridith | Ames IA | Certificate Signer's Address |
| Returned by Name | 'Mail' | | |