| What is the full name of child? | Bateman, Arthur Eldon |
| When was the child born? | April 28 1913 |
| Where was the child born? | [Illegible] |
| Male or Female | Male |
| Are the parents married? | Yes |
| Full name of Father | Bateman Thos A. |
| Occupation of Father? | Laborer |
| Full Maiden Name of Mother | Hill Emma |
| If she has been more than once married give names of former husband, or husbands | |
| Where were the parents married? | [Illegible] Stratford |
| When were they married? | March 26 1900 |
| If not married give full Name of Mother | |
| Is she single or a Widow? | |
| What is her occupation? | |
| Name of Physician attending | Ca???? ??? |
| Your relation to child | |
| Were you in house at time of Birth? | |
| Certified by | Mars A Bateman |
| Address | 224 Brunswick St |
| Date | May 26 1913 |
| Remarks |
Source: Archives of Ontario; Reel: 242; Record Group: Rg 80-2
Source: Ancestry.com. Ontario, Canada Births, 1832-1916