Grounded Field Extraction
Indiana Application for Search and Certified Copy of Birth Record
Hover a field to see its exact location highlighted on the document.
full_name_at_birth
Olivia Grace Bennett
95% confidence
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date_of_birth
05/14/1992
95% confidence
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place_of_birth_city
Fort Wayne
95% confidence
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hospital_name
Lutheran Hospital of Indiana
95% confidence
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parent_1_name
Michael T. Bennett
95% confidence
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parent_2_name
Sarah J. Bennett (nee Coleman)
95% confidence
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purpose
Passport application
95% confidence
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relationship
Self
95% confidence
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applicant_name
Olivia Grace Bennett
95% confidence
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mailing_address
742 Maplewood Drive, Fort Wayne, IN 46805
95% confidence
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telephone_number
(260) 555-0148
95% confidence
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total_fee.amount
10.00
96% confidence
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applicant_signature_block.printed_name
Olivia Grace Bennett
95% confidence
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applicant_signature_block.signature_date
07/28/2026
95% confidence
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applicant_signature_block.is_signed
YES
95% confidence
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applicant_signature_block.title_or_role
Signature of Applicant
95% confidence
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