Missouri Birth & Death Records Database

 

County	Roll Number	Page	Number
Polk	C 5519		768

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
10/04/1884	Spilman, Female 1st		09/09/1884 Green Twp

Nationality of Father Place of Birth	Age	Nationality of Mother Place of Birth	Age
U.S. Polk Co., MO	27	U.S. Polk Co., MO	28

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
Amelia A. Spilman Amelia A. Heart Green Twp	Samuel G. Spilman Farmer	J.F. Roberts, MD Bolivar, MO J.F. Roberts, MD J.F. Roberts, MD

NOTE
Bolivar, MO

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