| Type of record | Original Birth Record
|
| County of | Monroe
|
| Township of |
|
| Village of | Norwalk
|
| City of |
|
| Street & number or name of hospital |
|
| Full name of child | Carroll Owen Heffernan
|
| Sex of child | Male
|
| Color or race of child | White
|
| Twin, triplet or other? | Single
|
| Legitimate? | Yes
|
| Date of birth | July 22 1912
|
| FATHER: |
|
| Full name | M.O. Heffernan
|
| Residence | Norwalk Wis.
|
| Color or Race | White
|
| Age at time of this birth | 34
|
| Birthplace | Grant Co. Wis
|
| Occupation | Bank Cashier
|
| MOTHER: |
|
| Full maiden name | Mabel McGary
|
| Residence | Norwalk Wis.
|
| Color or Race | White
|
| Age at time of this birth | 33
|
| Birthplace | Norwalk Wis.
|
| Occupation | Housewife
|
| Number of children of this mother: |
|
| Born alive and now living | 3
|
| Born alive but now dead | 2
|
| Stillborn |
|
| Time of birth | 6:20 AM, July 22 1912
|
| Doctor | W.B. Ford, MD
|
| |
|
| Location of record | Monroe County Courthouse, Sparta, WI
|
| Volume | 8
|
| Page | 324
|
| Transcribed by | Bruce E. Kendall
|
| Transcription date | Aug. 24 2005
|
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