| Certificate Number | 152 | | Date Issued |
| Child Given Name | |
Harington | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 09 Jul 1885 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | Christ |
Harington | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | New York | 29 | Father's Age |
| Mother's Given Name | Dora A. | Crouch | Mother's Maiden Name |
| Mother's Surname | Harington | Collins Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 24 | 2 | Number of Child This Mother |
| Medical Attendant's Name | A.P. Edgar | Collins IA | Medical Attendant's Address |
| Certificate Signer's Name | A.P. Edgar | Collins IA | Certificate Signer's Address |
| Returned by Name | A.P. Edgar | | |