| Certificate Number | 37 | | Date Issued |
| Child Given Name | |
Cooper | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 05 Sep 1880 |
New Albany Twp Story Co IA | Place of Birth |
| Father's Given Name | Harrison Porter |
Cooper | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Story Co IA | 23 | Father's Age |
| Mother's Given Name | Margaret J. | Eatherton | Mother's Maiden Name |
| Mother's Surname | Cooper | New Albany Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Cedar Co IA | Mother's Birth Place |
| Mother's Age | 23 | 1 | Number of Child This Mother |
| Medical Attendant's Name | Jno Dougherty | Colo IA | Medical Attendant's Address |
| Certificate Signer's Name | Jno Dougherty | Colo IA | Certificate Signer's Address |
| Returned by Name | 'By Mail' | | |