| Certificate Number | 658 | | Date Issued |
| Child Given Name | |
Zwilling | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 06 May 1883 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Geo W. |
Zwilling | Father's Surname |
| Father's Occupation | Merchant | American | Father's Nationality |
| Father's Birth Place | Indiana | 30 | Father's Age |
| Mother's Given Name | Lovie S. | Letson | Mother's Maiden Name |
| Mother's Surname | Zwilling | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | American | Ohio | Mother's Birth Place |
| Mother's Age | 27 | 1 | Number of Child This Mother |
| Medical Attendant's Name | Geo. Stitzell | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | Geo. Stitzell | Nevada IA | Certificate Signer's Address |
| Returned by Name | Geo. Stitzell | | |