The minimum facts that must be established by documentary evidence shall be the following:

1. (1) The full name of the person at the time of birth;
2. (2) The date of birth and place of birth;
3. (3) The full maiden name of the mother; and
4. (4) The full name of the father, except that if the mother was not married to the father of the child either at the time of conception or birth or any time between conception and birth, the name of the father shall not be entered on the delayed certificate.