Arizona State Board of Health
Bureau of Vital Statistics
Standard Certificate of Birth

State File No 253
Registered No 130

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1. Place of Birth

County Navajo
State Arizona
Township Snowflake
City Snowflake

2. Full name of child Dorothy Smith

3. Sex Female

7. Is mother married? yes

8. Date of birth April 26, 1911

9. Father full name Hyrum Smith

10 Residence Snowflake

11 Color or race White

12 Age at last birthday 27 (years)

13 Birthplace Snowflake

14. Trade, profession or particular kind of work done  School Teacher

18. Mother Full maiden name June A. B. Smith

20. Color or race  white

21. Age at last birthday 30 (years)

22. Birthplace St. Joseph

I hereby certify that I attended the birth of this child, who was birn alive at 2 a.m. on the date above stated

Emma L. Smith, Midwife
Filed May 30 1911  P.R. Miller
Local Registrar

6/4/1911 Geo. P. Sampson
County Registrar