| Certificate Number | 233 | | Date Issued |
| Child Given Name | Willie |
Gatrell | Child Surname |
| Child Sex | Male |
W | Child Race |
| Date of Birth | 18 Aug 1890 |
Grant Twp Story Co IA | Place of Birth |
| Father's Given Name | Milton |
Gatrell | Father's Surname |
| Father's Occupation | Farmer | | Father's Nationality |
| Father's Birth Place | Ohio | 38 | Father's Age |
| Mother's Given Name | Agnes | Bell | Mother's Maiden Name |
| Mother's Surname | | Ames Story Co IA | Mother's Residence |
| Mother's Nationality | | Ohio | Mother's Birth Place |
| Mother's Age | 33 | 6 | Number of Child This Mother |
| Medical Attendant's Name | C.A. Beverly | Ames IA | Medical Attendant's Address |