Birth Certificate

FULL NAME OF CHILD

John Edward Hollenbough

Sex of Child

Male

Twin, Triplet or other?

-

Number in order of birth

-

Legitimate?

No

Date of birth

Oct 22 1920

FATHER

MOTHER

FULL NAME

Chester Hollenbough

FULL MAIDEN NAME

Faye Hollenbough

RESIDENCE Including P.O. Address

Middletown O

RESIDENCE Including P.O. Address

Middletown O

COLOR OR RACE

White

AGE AT LAST BIRTHDAY

24

COLOR OR RACE

White

AGE AT LAST BIRTHDAY

17

BIRTHPLACE

Ohio

BIRTHPLACE

Ohio

OCCUPATION AND INDUSTRY

Steel Worker

OCCUPATION AND INDUSTRY

Student

Number of children born to this mother, including present birth

1

Number of children of this mother now living

1

Was Prophylactic against Ophthalmia Neonatorum used?

Yes

CERTIFICATE OF ATTENDING PHYSICIAN OR MIDWIFE*

I hearby certify that I attended the birth of this child born to

Faye Hollenbough

and that the

child was

alive

at

2 P

M., on the date above stated.

(Signature)

Charles E Eha

-

Phys

-

(Physician or Midwife)

Address

2648 Erie Ave H 2

Filed

OCT 25 1920

E Walter Evans