| Certificate Number | 214 | | Date Issued |
| Child Given Name | Margaret L. |
Gill | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 1889 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | Geo. E. |
Gill | Father's Surname |
| Father's Occupation | Harness Maker | | Father's Nationality |
| Father's Birth Place | Wisconson | 28 | Father's Age |
| Mother's Given Name | Elizabeth C. | Milgate | Mother's Maiden Name |
| Mother's Surname | | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | New York | Mother's Birth Place |
| Mother's Age | 20 | 1 | Number of Child This Mother |
| Medical Attendant's Name | H.M. Templeton | Ames IA | Medical Attendant's Address |