| Certificate Number | 829 | | Date Issued |
| Child Given Name | Eugene |
Hemping | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 21 Nov 1883 |
New Albany Twp Story Co IA | Place of Birth |
| Father's Given Name | John N. |
Hemping | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Pennsylvania | 28 | Father's Age |
| Mother's Given Name | Louisa | Trites | Mother's Maiden Name |
| Mother's Surname | Hemping | New Albany Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 20 | 1 | Number of Child This Mother |
| Medical Attendant's Name | J.I. Hostetter | Colo IA | Medical Attendant's Address |
| Certificate Signer's Name | J.I. Hostetter | Colo IA | Certificate Signer's Address |
| Returned by Name | J.I. Hostetter | | |