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Note: Missouri Birth & Death Records Database Permanent Record of Births County Roll Number Page Number Ralls C 5618 237 Date of Return (Month/Day/Year) Name of Child Sex No. of Child of this Mother Race or Color Date of Birth Place of Birth 08/23/1884 Johnson, Male 8th White 8/24/1884 Center Twp Nationality of Father Place of Birth Age Nationality of Mother Place of Birth Age Amer Ralls Co. 45 Amer Amer 40 Full Name of Mother Maiden Name of Mother Residence of Mother Full Name of Father Occupation Name and Address of Medical Attendant Name and Address of Person making Certificate Returned by Rebecca L. Johnson Rebecca L. Jaques Center Twp Egbert Johnson Farmer A.A. Foster, Center, Mo A.A. Foster, MD Missouri Birth & Death Records Database Permanent Record of Births County Roll Number Page Number Ralls C 5618 237 Date of Return (Month/Day/Year) Name of Child Sex No. of Child of this Mother Race or Color Date of Birth Place of Birth 8/23/1884 Johnson, Male 8th White 8/24/1884 Center Twp Nationality of Father Place of Birth Age Nationality of Mother Place of Birth Age Amer Ralls Co 48 Amer Illinois 40 Full Name of Mother Maiden Name of Mother Residence of Mother Full Name of Father Occupation Name and Address of Medical Attendant Name and Address of Person making Certificate Returned by Rebecca L. Johnson Rebecca L. Jaques Center Twp Egbert Johnson Farmer N.A. Foster, Center, MO N.A. Foster, MD
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