Missouri Birth & Death Records Database
[ Permanent Record of Births] County Roll Number Page Number St. Clair C 9978 17
Date of Return(Month/Day/Year) 1. Name of Child 2. Sex 3. No. of Child of this Mother Race or Color 1. Date of Birth 2. Place of Birth 24/June/1884 1. Walters,White 1. 21/June/18842. Male2. Butler twp3. Third
1. Nationality of Father 2. Place of Birth Age 1. Nationality of Mother 2. Place of Birth Age 1. Kentucky34 1. Missouri24 2. Madison Co.2. Cooper Co.
1. Full Name of Mother 2. Maiden Name of Mother 3. Residence of Mother 1. Full Name of Father 2. Occupation Name and Address of Medical Attendant Name and Address of Person making Certificate Returned by 1. Martha Ellen Walters1. Leroy C. Walte[r]1. 2. Fry2. Farmer2. J.P. Wright, M.D. Lowry City, Mo.3. St. Clair County, Mo.3. NOTE
Due to possible errors or discrepancies in this abstract it is recommended that researchers request a print copy of the record by contacting archref@sosmail.state.mo.us