| Certificate Number | 143 | | Date Issued |
| Child Given Name | Maggie |
Halvorson | Child Surname |
| Child Sex | Female |
| Child Race |
| Date of Birth | 23 Mar 1881 |
New Albany Twp Story Co IA | Place of Birth |
| Father's Given Name | John |
Halvorson | Father's Surname |
| Father's Occupation | Farmer | Norwegian | Father's Nationality |
| Father's Birth Place | Norway | 42 | Father's Age |
| Mother's Given Name | Maggie | Mattinson | Mother's Maiden Name |
| Mother's Surname | Halvorson | New Albany Twp Story Co IA | Mother's Residence |
| Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
| Mother's Age | 43 | 11 | Number of Child This Mother |
| Medical Attendant's Name | Geo Frazee | Colo IA | Medical Attendant's Address |
| Certificate Signer's Name | Geo Frazee | Colo IA | Certificate Signer's Address |
| Returned by Name | 'Mail' | | |