| Certificate Number | 822 | | Date Issued |
| Child Given Name | Pearl J. |
Hedley | Child Surname |
| Child Sex | Female |
W | Child Race |
| Date of Birth | 21 Sep 1883 |
Nevada Story Co IA | Place of Birth |
| Father's Given Name | Seth |
Hadley | Father's Surname |
| Father's Occupation | Retired Farmer | American | Father's Nationality |
| Father's Birth Place | New Hampshire | 66 | Father's Age |
| Mother's Given Name | Sarah E. | Chandler | Mother's Maiden Name |
| Mother's Surname | Hadley | Nevada Story Co IA | Mother's Residence |
| Mother's Nationality | American | Iowa | Mother's Birth Place |
| Mother's Age | 19 | 1 | Number of Child This Mother |
| Medical Attendant's Name | P.W. Farrar | Nevada IA | Medical Attendant's Address |
| Certificate Signer's Name | P.W. Farrar | Nevada IA | Certificate Signer's Address |
| Returned by Name | P.W. Farrar | | |