| Child Given Name | George Ellis |
Dodds | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 05 Apr 1876 |
Franklin Twp Story Co IA | Place of Birth |
| Father's Given Name | Robert Nickson |
Dodds | Father's Surname |
| Father's Occupation | Farming | American | Father's Nationality |
| Father's Birth Place | Pennsylvania | 35 | Father's Age |
| Mother's Given Name | Lydia Anges | Hughes | Mother's Maiden Name |
| Mother's Surname | | Franklin Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Pennsylvania | Mother's Birth Place |
| Mother's Age | | 5 | Number of Child This Mother |
| Certificate Signer's Name | Ira Dodds | | Certificate Signer's Address |
| Returned by Name | Ira Dodds | | |