Muriel Simmons Christensen Harding
This Certificate must be forwarded by the local Registrar to the State Board of Health, Salt Lake City, on or before the 6th of the following month, after first having been properly registered.
State Board of Health File No.
Certificate of Birth
State of Utah
Place of Birth
County of Utah
Precinct of Spanish Fork
City of Spanish Fork
Full Name of Child: Muriel Simmons Christensen
If child is not yet named, make supplemental report, as directed
Sex of Child: Female
Legitimate: Yes
Date of Birth: Aug 22, 1910
Father Full Name: Isaac Christensen
Residence: Spanish Fork
Color: White
Age at last birthday: 27
Birthplace: Spanish Fork
Occupation: Farmer
Mother Full Maiden Name: Regina Simmons
Residence: Spanish Fork
Color: White
Age at last birthday: 24
Birthplace: Salt Lake, City
Occupation: None
Number of Child of this Mother: 4
Number of children of this Mother now living: 2
Certificate of Attending Physician or Midwife*
I hereby certify that I attended the birth of this child, and that it occured on August 22, 1910, at 10 a.m.
Premature or Still Birth: No
Signature
J.W. Hagan
M.D.
Date Sept 1 1910
Address of Physician or Midwife: Spanish Fork
Filed: Sep 1, 1910
Charles Mork? Registrar
Registered No. 104
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