| Certificate Number | 27 | | Date Issued |
| Child Given Name | Clara M. |
Aplin | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 26 Oct 1889 |
Cambridge Story Co IA | Place of Birth |
| Father's Given Name | Arthur S. |
Aplin | Father's Surname |
| Father's Occupation | Physician | | Father's Nationality |
| Father's Birth Place | Ohio | 37 | Father's Age |
| Mother's Given Name | Sylvia | Bossnot | Mother's Maiden Name |
| Mother's Surname | | Cambridge Story Co IA | Mother's Residence |
| Mother's Nationality | | Iowa | Mother's Birth Place |
| Mother's Age | 27 | 1 | Number of Child This Mother |
| Medical Attendant's Name | A.S. Aplin | Cambridge IA | Medical Attendant's Address |