Certificate Number | 931 | | Date Issued |
Child Given Name | |
Haaland | Child Surname |
Child Sex | Male |
W | Child Race |
Date of Birth | 07 Apr 1884 |
| Place of Birth |
Father's Given Name | George |
Haaland | Father's Surname |
Father's Occupation | Laborer | Norwegian | Father's Nationality |
Father's Birth Place | Norway | 26 | Father's Age |
Mother's Given Name | Martha | Furgeson | Mother's Maiden Name |
Mother's Surname | Haaland | Cambridge Story Co IA | Mother's Residence |
Mother's Nationality | Norwegian | Norway | Mother's Birth Place |
Mother's Age | 21 | 1 | Number of Child This Mother |
Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |
Certificate Signer's Name | J.M. Brown | Cambridge IA | Certificate Signer's Address |
Returned by Name | J.M. Brown | | |