| Certificate Number | 531 | | Date Issued |
| Child Given Name | Charles Edison Jr. |
Taylor | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 15 Apr 1887 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | Chas. E. |
Taylor | Father's Surname |
| Father's Occupation | Clerk | | Father's Nationality |
| Father's Birth Place | Pennsylvania | 42 | Father's Age |
| Mother's Given Name | Nancy M. | Wilder | Mother's Maiden Name |
| Mother's Surname | Taylor | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Wisconson | Mother's Birth Place |
| Mother's Age | 37 | 5 | Number of Child This Mother |
| Medical Attendant's Name | H.M. Templeton | Ames IA | Medical Attendant's Address |