| Certificate Number | 232 | | Date Issued |
| Child Given Name | |
Dayton | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 04 Oct 1887 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | E.A. |
Dayton | Father's Surname |
| Father's Occupation | Jeweler | | Father's Nationality |
| Father's Birth Place | Illinois | 33 | Father's Age |
| Mother's Given Name | Mary L. | King | Mother's Maiden Name |
| Mother's Nationality | | Illinois | Mother's Birth Place |
| Mother's Age | 28 | 4 | Number of Child This Mother |
| Medical Attendant's Name | Geo. Stitzell | Nevada IA | Medical Attendant's Address |