| Certificate Number | 32 | | Date Issued |
| Child Given Name | Rasmus |
Nelson | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 29 Oct 1888 |
Richland Twp Story Co IA | Place of Birth |
| Father's Given Name | Cegar |
Nelson | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Denmark | 42 | Father's Age |
| Mother's Given Name | Christina | Rasmusson | Mother's Maiden Name |
| Mother's Surname | | Richland Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Denmark | Mother's Birth Place |
| Mother's Age | 41 | 2 | Number of Child This Mother |
| Medical Attendant's Name | F.S. Newton | Zearing IA | Medical Attendant's Address |