| Certificate Number | 679 | | Date Issued |
| Child Given Name | Arthur Lee |
Hale | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 10 Dec 1887 |
Collins Twp Story Co IA | Place of Birth |
| Father's Given Name | Howard |
Hale | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Cook Co IL | | Father's Age |
| Mother's Given Name | Eta | Marsh | Mother's Maiden Name |
| Mother's Nationality | American | Collins Twp Story Co IA | Mother's Birth Place |
| Mother's Age | | 2 | Number of Child This Mother |
| Medical Attendant's Name | A.P. Edgar | Collins IA | Medical Attendant's Address |