Missouri Digital Heritage :: Collections :: Birth & Death Records Database :: Birth Record Detail

Missouri Birth & Death Records Database

Permanent Record of Births

County Roll Number Page Number
Moniteau C 4543 48 622

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
June 9 1885
  1. (?)ill Ann Ray & Gray Ray
  2. m & F
  3. (twins) 11
Negro
  1. June 8 1885
  2. California Mo

  1. Nationality of Father
  2. Place of Birth
Age
  1. Nationality of Mother
  2. Place of Birth
Age
  1. American
  2. Smithton Cooper Co Mo
37

  1. Full Name of Mother
  2. Maiden Name of Mother
  3. Residence of Mother
  1. Full Name of Father
  2. Occupation
  1. Name and Address of Medical Attendant
  2. Name and Address of Person making Certificate
  3. Returned by
  1. Milly Ray
  2. Milly Ray
  3. California Mo
  1. L M Gray MD California Mo
  2. Gray & Son MD

NOTE
 


Due to possible errors or discrepancies in this abstract it is recommended that researchers request a print copy. To request a copy of this record, please print a copy of this page and mail it to the Missouri State Archives, PO Box 1747, 600 W. Main Street,  Jefferson City, MO  65101 with a check or money order for $1.00 made payable to the Missouri State Archives.  Please include a #10 business size, stamped, self-addressed envelope with each request.  Please submit one photocopy request at a time.
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