First things and last : the story of birth and death certificates.
- United States. National Office of Vital Statistics
- Date:
- [1960]
Licence: Public Domain Mark
Credit: First things and last : the story of birth and death certificates. Source: Wellcome Collection.
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![(unless he is obviously over legal age) are dependent upon the ability to prove the date of his birth. Such proof is also necessary if, at any time, he should require public assistance, either as a dependent child or as a needy aged person. On this proof, too, may depend his right to collect a retirement or disability pension under the system of social security insurance. In addition, while it is, of course, obvious that a per- son was born, it is equally important, as Will Rogers once said, to know ‘‘when, where at, and who to.’’ These facts help establish proof of parentage, identity, the right of inheritance, and legal dependency; they may also help to settle insurance claims. Further, citizenship is determined through proof of place of birth and parentage. This will be of importance when it is necessary to secure a passport to travel abroad. Form approved. Budget iets No. 686-R3743. eaten Missouri CERTIFICATE OF LIVE BIRTH Binva os 1. Peace ba BIRTH 2. cpap wer aot ie OF MOTHER fWrere soe mother live?) a, COUN a. . COUN’ Dent Missouri Dent : ve ie ine : Salem Cit: Spring Creek ¢. NAME OF (Lf not in hospital, give street address) d, STREET ADDRESS HOSPITAL OR ms 0-) 2 istiTuTioN Grandview Hospital Five Corners ° Td. 1S PLACE OF BIRTH INSIDE CITY LIMITS? €. IS RESIDENCE INSIDE CITY LIMITS? f. 1S RESIDENCE ON A FARM? coed ]”. SEE Le TE ee Tee mers Dee A | ves oO 3. NAME Firat Middle (Type or nt) George Hen Coe 5a. THIS BIRTH 5b. IF TWIN OR TRIPLET. WAS CHILD BORN 6. DATE Month Day Year OF sincLe (B twin rripcet LJ ist 20 3200 arth March 8 1958 7. NAME Middle 8. COLOR OR RACE Robert Thomas Coe White. 9. AGE (Al lime of this birth) 10, BIRTHPLACE (State or foreign country) 116. KIND OF BUSINESS OR INDUSTRY eect EMS Li iinois | Farm Laborer 0) Ferm 12. MAIDEN NAME First Middle Last 13. COLOR OR RACE Sarah Jane Mathews White 14. AGE (Af time of this birth) 15. BIRTHPLACE (State or foreign country) 16. PREVIOUS DELIVERIES TO MOTHER (Do NOT include (his birth) 26 YEARS Missouri 6. How many b. How many OTHER chil- |e, How many — a —— were born alive bul are | (fetuses born 17. INFORMANT a now dead? ime o, ton)? Sarah Jane Coe 18. MOTHER'S MAILING ADDRESS Spring Creek, Missouri 1956 REVISION OF STANDARD CERTIFICATE 1 hereby certify inet thie cate 4 ~ SEZ LZELZE 7), & m0. 0.0.0) miowire() OTHER (Specify) was born alive i = on tl dat. 18, ADDRESS 184. DATE SIGNED 205 Elm St., Salem City, Missouri March 9, 1958 19. DATE RECD. BY LOCAL REG. 2D. REGISTRAR'S SIGNATURE * 21. DATE ON WHICH GIVEN NAME ADDED March 10, 1958 Br ° S . FroukQi— By (Registrar) @ FOR MEDICAL AND HEALTH USE ONLY (This section MUST be filled out) 22a. LENGTH OF PREGNANCY 226. WEIGHT AT BIRTH 2. LEGITIMATE COMPLETED 38 WEEKS 71s. 2 oz. yes no C) (SPACE FOR ADDITION OF MEDICAL AND HEALTH ITEMS BY INDIVIDUAL STATES) DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—PUBLIC HEALTH SERVICE PHS-795 RE. 11-34](https://iiif.wellcomecollection.org/image/b32177471_0005.jp2/full/800%2C/0/default.jpg)
