| Certificate Number | 168 | | Date Issued |
| Child Given Name | James B. |
Alderman | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 01 Apr 1889 |
Ames Story Co IA | Place of Birth |
| Father's Given Name | J.P. |
Alderman | Father's Surname |
| Father's Occupation | Rag dealer | | Father's Nationality |
| Father's Birth Place | Morgan Co OH | 45 | Father's Age |
| Mother's Given Name | Martha | Pierce | Mother's Maiden Name |
| Mother's Surname | | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Missouri | Mother's Birth Place |
| Mother's Age | 40 | 9 | Number of Child This Mother |
| Medical Attendant's Name | H.M. Templeton | Ames IA | Medical Attendant's Address |