Certificate Number | 190 | | Date Issued |
Child Given Name | Day Edward |
King | Child Surname |
Child Sex | Male |
| Child Race |
Date of Birth | 01 Jun 1881 |
Nevada Story Co IA | Place of Birth |
Father's Given Name | Jay A. |
King | Father's Surname |
Father's Occupation | County Treasurer | American | Father's Nationality |
Father's Birth Place | Akron OH | 35 | Father's Age |
Mother's Given Name | Lillie E. | Day | Mother's Maiden Name |
Mother's Surname | King | Nevada Story Co IA | Mother's Residence |
Mother's Nationality | American | Nevada Story Co IA | Mother's Birth Place |
Mother's Age | 24 | 1 | Number of Child This Mother |
Medical Attendant's Name | J.S. Lowell | Nevada IA | Medical Attendant's Address |
Certificate Signer's Name | J.S. Lowell | Nevada IA | Certificate Signer's Address |
Returned by Name | J.S. Lowell | | |