| Certificate Number | 769 | | Date Issued |
| Child Given Name | Bertha Viola |
McGrath | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 13 Jul 1883 |
Colfax Twp Boone Co iA | Place of Birth |
| Father's Given Name | Thomas D. |
McGrath | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Illinois | 32 | Father's Age |
| Mother's Given Name | Elizabeth | Anderson | Mother's Maiden Name |
| Mother's Surname | McGrath | Boone IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 28 | 2 | Number of Child This Mother |
| Medical Attendant's Name | J. Bradley | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | J. Bradley | Ames IA | Certificate Signer's Address |
| Returned by Name | J. Bradley | | |