Certificate Number | 494 | | Date Issued |
Child Given Name | |
Downing | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 02 Jun 1882 |
Collins Twp Story Co IA | Place of Birth |
Father's Given Name | David Thomas |
Downing | Father's Surname |
Father's Occupation | Farmer | American | Father's Nationality |
Father's Birth Place | New York | 27 | Father's Age |
Mother's Given Name | Mary A.C. | Kluie | Mother's Maiden Name |
Mother's Surname | Downing | Collins Twp Story Co IA | Mother's Residence |
Mother's Nationality | American | Iowa | Mother's Birth Place |
Mother's Age | 22 | 1 | Number of Child This Mother |
Medical Attendant's Name | L.H. Bennett M.D. | Clyde IA | Medical Attendant's Address |
Certificate Signer's Name | L.H. Bennett M.D. | Clyde IA | Certificate Signer's Address |
Returned by Name | L.H. Bennett M.D. | | |