Source language: English
Certification of vital record.
I certify that this child was born alive at the place and time and on the date stated.
I certify that the personal information provided on this certificate is correct to the best of my knowledge and belief.
this is to certify that this is a true and correct copy from the official record filed with the illinois department of health.
Any alteration or erasure voids this certificate.
Certifier attendant :
Attendant's mailing address :