| Certificate Number | 231 | | Date Issued |
| Child Given Name | |
Drummond | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 22 Aug 1889 |
Washington Twp Story Co IA | Place of Birth |
| Father's Given Name | D.W. |
Drummund | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Indiana | 26 | Father's Age |
| Mother's Given Name | Anna | Sills | Mother's Maiden Name |
| Mother's Surname | | Washington Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Indiana | Mother's Birth Place |
| Mother's Age | 20 | 1 | Number of Child This Mother |
| Medical Attendant's Name | A. Richmond | Ames IA | Medical Attendant's Address |