Attending phys. - O. (C?) W. Slaughlin, MD; Westerville,OH; Geo L Farnlacher & Bertha Caroline Ballard; parent's address at birth: Westerville,OH; date birth cert filed-Jul 28, 1922; Westerville is in Franklin County; at birth, George' occupation--mechanic, Bertha's--housewife; Regn dist #391, Pri. regn dist #2419, file #61856, registered #51. Place of birth: George--Westerville,OH, Bertha--Greenfield,OH; ages: George--34, Bertha--24. Number of children born & living, including this child: 3. "Was prophylactic against ophthalmia neonatorum used? Yes". Mis-spelling in full name of child: "Carl Ballard Farnlacher", should be "Karl" (by Karl himself).
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