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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.