| Certificate Number | 129 | | Date Issued |
| Child Given Name | |
Marsh | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 15 Mar 1889 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Dwight W. |
Marsh | Father's Surname |
| Father's Occupation | Confectioner | | Father's Nationality |
| Father's Birth Place | Warren Co PA | 32 | Father's Age |
| Mother's Given Name | Jennie | Klingaman | Mother's Maiden Name |
| Mother's Surname | | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | | Michigan | Mother's Birth Place |
| Mother's Age | 22 | 1 | Number of Child This Mother |
| Medical Attendant's Name | H.D. Chamberlin | Nevada IA | Medical Attendant's Address |