| Certificate Number | 296 | | Date Issued |
| Child Given Name | |
Enos | Child Surname |
| Child Sex | Male |
| Child Race |
| Date of Birth | 03 Jan 1882 |
Lincoln Twp Story Co IA | Place of Birth |
| Father's Given Name | Eugene |
Enos | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Pennsylvania | 34 | Father's Age |
| Mother's Given Name | Elmira E. | Burkhart | Mother's Maiden Name |
| Mother's Surname | Enos | Lincoln Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | New York | Mother's Birth Place |
| Mother's Age | 31 | 7 | Number of Child This Mother |
| Medical Attendant's Name | F.S. Newton M.D. | Zearing IA | Medical Attendant's Address |
| Certificate Signer's Name | F.S. Newton M.D. | Zearing IA | Certificate Signer's Address |
| Returned by Name | F.S. Newton M.D. | | |