| Certificate Number | 331 | | Date Issued |
| Child Given Name | |
Hamilton | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 30 Jun 1886 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | Wm H. |
Hamilton | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | New York | 46 | Father's Age |
| Mother's Given Name | Caroline | | Mother's Maiden Name |
| Mother's Surname | Hamilton | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Norway | Mother's Birth Place |
| Mother's Age | 36 | 6 | Number of Child This Mother |
| Medical Attendant's Name | E.B. Plumb | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | E.B. Plumb | Ames IA | Certificate Signer's Address |
| Returned by Name | E.B. Plumb | | |