| Certificate Number | 799 | | Date Issued |
| Child Given Name | Ida Undina |
Baldwin | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 02 Oct 1883 |
Lincoln Twp Story Co IA | Place of Birth |
| Father's Given Name | T.Z. |
Baldwin | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | New York | 33 | Father's Age |
| Mother's Given Name | Sevella E. | Brown | Mother's Maiden Name |
| Mother's Surname | Baldwin | Lincoln Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Illinois | Mother's Birth Place |
| Mother's Age | 28 | 4 | Number of Child This Mother |
| Medical Attendant's Name | Baldwin | | Medical Attendant's Address |
| Certificate Signer's Name | A.W. Brooks | Zearing IA | Certificate Signer's Address |
| Returned by Name | A.W. Brooks | | |