| Certificate Number | 51 | | Date Issued |
| Child Given Name | Flossie Pearl |
Armstrong | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 13 Jan 1888 |
Zearing Story Co IA | Place of Birth |
| Father's Given Name | Jessie |
Armstrong | Father's Surname |
| Father's Occupation | Clerk | | Father's Nationality |
| Father's Birth Place | Iowa | 21 | Father's Age |
| Mother's Given Name | Lucy | Williams | Mother's Maiden Name |
| Mother's Surname | Armstrong | | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 17 | 1 | Number of Child This Mother |
| Medical Attendant's Name | F.S. Newton | Zearing IA | Medical Attendant's Address |