| Certificate Number | 339 | | Date Issued |
| Child Given Name | Homer Allen |
Stratten | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 08 Feb 1882 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | Simon C. |
Stratten | Father's Surname |
| Father's Occupation | Farmer & Gardner | American | Father's Nationality |
| Father's Birth Place | Henry Co IN | 38 | Father's Age |
| Mother's Given Name | Mary Ann | Newark | Mother's Maiden Name |
| Mother's Surname | Stratten | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | American | Ohio | Mother's Birth Place |
| Mother's Age | | 8 | Number of Child This Mother |
| Medical Attendant's Name | Hannah, Mrs. Savitta | | Medical Attendant's Address |
| Certificate Signer's Name | J.L., Mrs. Bartlett M.D. | | Certificate Signer's Address |
| Returned by Name | J.L., Mrs. Bartlett M.D. | | |