| Certificate Number | 527 | | Date Issued |
| Child Given Name | Alura |
Elliott | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 03 Dec 1882 |
Richland Twp Story Co IA | Place of Birth |
| Father's Given Name | Freeman |
Elliott | Father's Surname |
| Father's Occupation | Farmer | American | Father's Nationality |
| Father's Birth Place | Illinois | 44 | Father's Age |
| Mother's Given Name | Alura M. | Lake | Mother's Maiden Name |
| Mother's Surname | Elliott | Richland Twp Story Co IA | Mother's Residence |
| Mother's Nationality | American | Illinois | Mother's Birth Place |
| Mother's Age | 42 | 8 | Number of Child This Mother |
| Medical Attendant's Name | Mrs. Mead | Richland Twp IA | Medical Attendant's Address |
| Certificate Signer's Name | Mrs. Mead | Richland Twp IA | Certificate Signer's Address |
| Returned by Name | Freeman Elliott | | |