| Certificate Number | 116 | | Date Issued |
| Child Given Name | |
Egland | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 14 Mar 1888 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Thos. E. |
Egland | Father's Surname |
| Father's Occupation | Laborer | | Father's Nationality |
| Father's Birth Place | Story Co IA | 29 | Father's Age |
| Mother's Given Name | | Reed | Mother's Maiden Name |
| Mother's Surname | | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | | Norway | Mother's Birth Place |
| Mother's Age | 24 | 4 | Number of Child This Mother |
| Medical Attendant's Name | Annie, Mrs. Red | Cambridge IA | Medical Attendant's Address |