| Certificate Number | 272 | | Date Issued |
| Child Given Name | Arthur E. |
Thorson | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 23 Jul 1889 |
Palestine Twp Story Co IA | Place of Birth |
| Father's Given Name | Gilbert |
Thorson | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Illinois | 24 | Father's Age |
| Mother's Given Name | Mary | Arnts | Mother's Maiden Name |
| Mother's Surname | | Palestine Twp Story Co IA | Mother's Residence |
| Mother's Nationality | | Story Co IA | Mother's Birth Place |
| Mother's Age | 26 | 3 | Number of Child This Mother |
| Medical Attendant's Name | A.S. Aplin | Cambridge IA | Medical Attendant's Address |