| Certificate Number | 50 | | Date Issued |
| Child Given Name | Alice Florence |
Holmes | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 10 Sep 1880 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | Thomas |
Holmes | Father's Surname |
| Father's Occupation | Farmer | Englishman | Father's Nationality |
| Father's Birth Place | England | 24 | Father's Age |
| Mother's Given Name | Dora May | McQuiston | Mother's Maiden Name |
| Mother's Surname | Holmes | Story Co IA | Mother's Residence |
| Mother's Nationality | American | Jasper Co IA | Mother's Birth Place |
| Mother's Age | 20 | 1 | Number of Child This Mother |