This is a scanned copy of a birth record. The information in the boxes are as follows:
Vater (Father), his parents, and where they lived.
Box #2 Mütter (Mother), her parents and where they lived.
Box #3 is the godparents.
What I can read: Box 1: Johann Bellmann born (possibly in Haidl) No. 16, song of Joseph Bellmann born (Possibly in Haidl)
Box 2: Possibly Eva Theresia Reithmaier of Haidl No. 16, daughter of Jacob Reithmaier of Haidl No. 16 and ____
Godparent is Joseph (Reithmaier) Haidl No 17
Any help would be most appreciated!