I work with graphic arts. I can honestly say that this document is more than likely real. I will also say that there has been some attempts to make the document more readable after scanning. I have done this in photoshop myself for documents I’ve scanned. For example, I might adjust levels to make the document more true to black and white in order to make the letters stand out. Certain portions of the document might not have scanned as dark, and I might isolate that section into another layer to adjust the levels and other image adjustments. I might also then remove the background in order to get a pure white… especially if the background had too many patchy gray areas. That would necessitate me placing the text into a separate layer.
What I would have done (that they did not do), was combine the layers before saving the image as a PDF file. That was probably the result of someone in a hurry who saved too quickly (or doesn’t know what they are doing).
No, I do not think this was the result of the OCR process. The big tip off is the patterned background that has been inserted to make the document look nice. You can see where the document was stored in a book and falls off on the left hand side. I’d have removed that if I could or left it in it’s entirety to include the signature portion. The person who did the clean up removed that part of the scan.
I would guess the original document was on plane white paper that had yellowed and faded enough that the scanner could not pick up the text without some fading. Why they felt the need to include that green patterned background is beyond me?
OK, Sonic, I’m trying to follow you…

I understand, more or less, what you are saying.
One thing that comes to mind, this copy of the BC has a signature on the bottom, from some doc (some Ph.D.), dated April 2011. So, I guess, that doc guarantees that the copy of the Long-form certificate issued to President Omama’s staff member is in fact a legitimate copy of the original BC which has been kept and will remain kept with the Kapiolani hospital. The original, with original signatures, must be a 50-year old piece of paper, possibly a plain white paper (no green watermark type background). Maybe the copy was made onto the green-patterned paper because it’s their standard procedure to issue birth certificates on that kind of paper - it cannot be easily forged by people who don’t have access to it
Maybe what Kapiolani did (this is just my speculation), they photocopied the original BC on this fancy green-and-white paper, and gave the photocopy to the staff member. Then, the staff member brought the photocopy to Washington DC, someone scanned the photocopy, touched it up with an image editing software in order to make it easier to read, and uploaded it on the Whitehouse web site.
I found this internet forum on which specialists debate the technical details of the pdf image of the Birth Certificate posted on the Whitehouse website:
abovetopsecret.com/forum/thread694949/pg61