| Certificate Number | 83 | | Date Issued |
| Child Given Name | Torger |
Haaland | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 23 Jan 1888 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Geo. F. |
Haaland | Father's Surname |
| Father's Occupation | Railroader | | Father's Nationality |
| Father's Birth Place | Norway | 30 | Father's Age |
| Mother's Given Name | Martha G. | Torgeson | Mother's Maiden Name |
| Mother's Surname | | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | | Norway | Mother's Birth Place |
| Mother's Age | 25 | 3 | Number of Child This Mother |
| Medical Attendant's Name | J.M. Brown | Cambridge IA | Medical Attendant's Address |