Birth RecordsHeld by an archive
1915 Pennsylvania Certificate of Birth (certified copy issued 1929) – Gladys Davis, born 28 Feb 1915, Grier City, Ryan Township, Schuylkill County
Transcript
Uncertain readings are marked [?] or set in brackets; words that could not be read are marked as such. Each transcript is shown as written, with its transcriber’s notes.
The record
Transcription of: 1915_Birth_Record_Gladys_Davis.pdf
Document: Certified copy (Form V.S. No. 34) of a Commonwealth of Pennsylvania Department of Health, Bureau of Vital Statistics Certificate of Birth (Form V.S. No. 11), printed form completed in handwriting; signed by the State Registrar and dated June 17, 1929 by hand; embossed seal faintly visible.
Conventions: original spelling kept; [?] = uncertain reading; [illegible] = unreadable; bracketed italic text describes images or marks the transcriber's notes.
Transcription
| Form | Form V. S. No. 34 |
| Certificate number (stamped, upper right) | 183748 |
This is to Certify, That the following is a true and correct copy of a certificate of birth, filed in the Bureau of Vital Statistics, Pennsylvania Department of Health, as directed by the Act of the General Assembly.
| (State Registrar) [signature] | Evelyn Jones [?] |
| [Handwritten date, left margin] | June 17, 1929 |
[Embossed seal, faint, upper left of the form area; not legible.]
Form V. S. No. 11 — COMMONWEALTH OF PENNSYLVANIA — DEPARTMENT OF HEALTH — BUREAU OF VITAL STATISTICS — CERTIFICATE OF BIRTH
| 1. Place of Birth – County of | Schuylkill |
| Township of | Ryan |
| Borough of | [blank] |
| City of | Grier |
| Registration District No. | 792 |
| File No. | 41744 |
| Primary Registration District No. | 3216 |
| Registered No. | 148 |
| 2. Full name of child | Gladys Davis |
| 3. Sex of child | Female |
| 4./5. Twin, triplet or other / Number in order of birth | [blank] |
| 6. Legitimate | Yes |
| 7. Date of birth (Month) (Day) (Year) | 2 - 28, 1915 |
FATHER
| 8. Full name | David Davis |
| 9. Residence (usual place of abode) / 9a. P. O. Address | Grier City |
| 10. Color or race | White |
| 11. Age at last birthday (years) | 47 |
| 12. Birthplace, City, State or Country | England |
| 13. Occupation, Nature of Industry | Miner |
MOTHER
| 14. Full maiden name | Harriet Parish |
| 15. Residence (usual place of abode) / 15a. P. O. Address | Grier City |
| 16. Color or race | [blank] |
| 17. Age at last birthday (years) | 37 |
| 18. Birthplace, City, State or Country | England |
| 19. Occupation, Nature of industry | Housewife |
| 20. Number of children of this mother (including present birth) – A. Born alive and now living | 4 |
| B. Born alive and now dead | [blank] |
| C. Stillborn | [blank] |
CERTIFICATE OF ATTENDING PHYSICIAN OR MIDWIFE*
I hereby certify that I attended the birth of this child, who was Born alive (Born Alive or Stillborn) at 2 P. M on the date above stated.
| (Signature) | Harriet [?] I. [?] Evans M.D |
| (Physician or Midwife) | ["or Midwife" struck through] |
| Address | Mahanoy City Pa. |
| Filed | Apr. 2 1915 |
| Local Registrar | J. H. Kirchner |
| Given name added from a supplemental report ___ 19__ / Local Registrar | [blank] |
[Printed left margin:] MARGIN RESERVED FOR BINDING. WRITE PLAINLY WITH UNFADING INK—THIS IS A PERMANENT RECORD. N. B.—In case of more than one child at a birth, a SEPARATE RETURN must be made for each, and the number of each in order of birth stated. If birth occurred in a hospital or institution, give its NAME instead of street and number.
[Printed box:] *When there was no attending physician or midwife, then the father, householder, etc., should make this return. A stillborn child is one that neither breathes nor shows other evidence of life after birth.
Transcriber's Notes
Place of birth: County 'Schuylkill', Township 'Ryan', City 'Grier' (residences given as 'Grier City'); the handwriting is clear.
State Registrar signature read as 'Evelyn Jones' — the first name is a flourished signature and uncertain.
Mother's maiden surname reads 'Parish' (single r); the initial letter is a looped capital P.
Physician's signature: 'Harriet' and middle initial 'I.' [or 'J.'] uncertain; surname 'Evans' and 'M.D' clear.
Local Registrar signature read as 'J. H. Kirchner'; the 'H' could be 'N'.
Color or race for the mother (item 16) appears blank.