| No. | 049975 33 |
| What is the full name of child? | Foster Irene Gertrude |
| When was the child born? | August 5' 1910 |
| Where was the child born? | Todd Street |
| Sex | Female |
| Are the parents married? | yes |
| Full name of Father | Clayton John Foster |
| Occupation of Father | Carder |
| Full Maiden Name of Mother | Mary Ellen Callaghan |
| If she has been more than once married give names of former husband, or husbands | No |
| Where were the parents married? | Markham |
| When were the parents married? | 20 Decr. 1900 [sic] |
| Name of Physician in Attendance | Dr. A. Hawk |
| Your relation to child | Father |
| Were you in house at time of Birth? | Yes |
| Certified by | Clayton Foster |
| Address | |
| Date | August 29' 1910 |
| Remarks |
Source: Archives of Ontario; Series: MS929; Reel: 214
Source: Ancestry.com. Ontario, Canada Births, 1858-1913