| Child Given Name | Joe |
Gooden | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 31 Aug 1888 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Edwin David |
Gooden | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Iowa | 30 | Father's Age |
| Mother's Given Name | Viola Vianna | Appelgate | Mother's Maiden Name |
| Mother's Surname | | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 29 | 5 | Number of Child This Mother |
| Certificate Signer's Name | B.M. Appelgate | Nevada IA | Certificate Signer's Address |