Certificate Number | 582 | | Date Issued |
Child Given Name | L.T. |
Fowler | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 18 May 1887 |
Elkart Twp Polk Co IA | Place of Birth |
Father's Given Name | L.T. |
Fowler | Father's Surname |
Father's Occupation | Farmer | | Father's Nationality |
Father's Birth Place | Iowa | 27 | Father's Age |
Mother's Given Name | Mary | Hall | Mother's Maiden Name |
Mother's Surname | Fowler | | Mother's Residence |
Mother's Nationality | | Ohio | Mother's Birth Place |
Mother's Age | 29 | 1 | Number of Child This Mother |
Medical Attendant's Name | A.S. Aplin | Cambridge IA | Medical Attendant's Address |