| Certificate Number | 41 | | Date Issued |
| Child Given Name | Alta |
Hawthorne | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 27 Aug 1880 |
Nevada Twp Story Co IA | Place of Birth |
| Father's Given Name | James M. |
Hawthorne | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Illinois | 18 | Father's Age |
| Mother's Given Name | Kittie S. | Coe | Mother's Maiden Name |
| Mother's Surname | Hawthorne | Nevada Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 22 | 1 | Number of Child This Mother |