| Certificate Number | 511 | | Date Issued |
| Child Given Name | |
McNaughton | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 23 Feb 1887 |
Colfax Twp Boone Co iA | Place of Birth |
| Father's Given Name | David |
McNaughton | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Iowa | 26 | Father's Age |
| Mother's Given Name | Mary J. | Zenor | Mother's Maiden Name |
| Mother's Surname | | Colfax Twp Boone Co IA | Mother's Residence |
| Mother's Nationality | | Story Co IA | Mother's Birth Place |
| Mother's Age | | 3 | Number of Child This Mother |
| Medical Attendant's Name | H.M. Templeton | | Medical Attendant's Address |