| Certificate Number | 324 | | Date Issued |
| Child Given Name | |
Osborn | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 28 Dec 1881 |
Franklin Twp Story Co IA | Place of Birth |
| Father's Given Name | Thomas |
Osborn | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Iowa | 24 | Father's Age |
| Mother's Given Name | Mattie | Dye | Mother's Maiden Name |
| Mother's Surname | Osborn | Franklin Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 21 | 1 | Number of Child This Mother |
| Medical Attendant's Name | G.A. Merideth | Ames IA | Medical Attendant's Address |
| Certificate Signer's Name | 'By Mail' | | Certificate Signer's Address |
| Returned by Name | 'By Mail' | | |