| Certificate Number | 309 | | Date Issued |
| Child Given Name | J. |
Zenor | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 03 Nov 1888 |
Gilbert Story Co IA | Place of Birth |
| Father's Given Name | John P. |
Zenor | Father's Surname |
| Father's Occupation | Merchant | | Father's Nationality |
| Father's Birth Place | Indiana | 40 | Father's Age |
| Mother's Given Name | Irene | Garaway | Mother's Maiden Name |
| Mother's Surname | | Gilbert Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 22 | 2 | Number of Child This Mother |
| Medical Attendant's Name | C.A. Beverly | Ames IA | Medical Attendant's Address |