| Certificate Number | 634 | | Date Issued |
| Child Given Name | Hannah Augusta |
Glasgow | Child Surname |
| Child Sex | G |
W | Child Race |
| Date of Birth | 08 Apr 1883 |
Iowa Center Story Co IA | Place of Birth |
| Father's Given Name | David C. |
Glasgow | Father's Surname |
| Father's Occupation | Mason | American | Father's Nationality |
| Father's Birth Place | Virginia | 42 | Father's Age |
| Mother's Given Name | C.A. | Wilcox | Mother's Maiden Name |
| Mother's Surname | Glasgow | Iowa Center Story Co IA | Mother's Residence |
| Mother's Nationality | American | Illinois | Mother's Birth Place |
| Mother's Age | 37 | 10 | Number of Child This Mother |
| Medical Attendant's Name | Frank Thompson | Iowa Center IA | Medical Attendant's Address |
| Certificate Signer's Name | Frank Thompson | Iowa Center IA | Certificate Signer's Address |
| Returned by Name | Frank Thompson | | |