| Certificate Number | 391 | | Date Issued |
| Child Given Name | |
Harrington | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 08 Apr 1882 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | Christofer |
Harrington | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Mother's Given Name | Eldora Adeline | Crouch | Mother's Maiden Name |
| Mother's Surname | Harrington | | Mother's Residence |
| Mother's Nationality | American | | Mother's Birth Place |
| Mother's Age | | 1 | Number of Child This Mother |
| Medical Attendant's Name | L.H. Burnett M.D. | | Medical Attendant's Address |
| Certificate Signer's Name | L.H. Burnett M.D. | | Certificate Signer's Address |
| Returned by Name | L.H. Burnett M.D. | | |