| Certificate Number | 233 | | Date Issued |
| Child Given Name | |
Hand | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 11 Oct 1887 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Wm. T. |
Handsaker | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Ohio | 34 | Father's Age |
| Mother's Given Name | Jane | Sheperd | Mother's Maiden Name |
| Mother's Surname | | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 34 | 3 | Number of Child This Mother |
| Medical Attendant's Name | Geo Stitzell | Nevada IA | Medical Attendant's Address |