| NEW SOUTH WALES BIRTH CERTIFICATE |
REGISTRATION NUMBER 1865/011428 |
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| Record number | Date and place of birth of child | Name and whether present or not | Sex | Father's name, occupation, age and birthplace | Date and place of marriage – previous issue | Mother's name and maiden surname, age and birthplace |
| 20 | 14th December 1864 Pipeclay |
Annie Louisa Margaret Not present |
Female | (1) William Okey (2) Innkeeper (3) 28 years (4) London |
(1) 4th January 1864 Namoi River N. S. Wales (2) None |
(1) Anna Maria formerly King (2) 18 years (3) Warwick Queensland |
| Informant | Witness | Particulars of registration | Name if added after Registration of birth |
| William Okey Father Pipeclay |
(1) W. Ramsey M. D. (2) Mrs Hogan (3) |
Stafford H Barrie 16th January 1865 Mudgee |