They *exist*, but you *have to know how to use them*.
Indications from the document are consistent with someone who DIDN'T.
And that is inconsistent with a genuine birth certificate, as the real typists from the Hawaii Dept. of Red Tape back then would've known how to use them consistently.
If a typist who was in the middle of typing up some documents whose tab stops were different from those used on birth certificates, was asked to type up a single birth certificate, would that typist be more likely to change the tab stops to match the certificate and then change them all back, or to simply eyeball the spacing for the certificate?
I doubt that in 1960 any of the people typing up birth certificates cared much about alignment and spacing, provided that nothing was so badly misaligned as to be unreadable. If an examination of all the certificates produced by that hospital that year showed that BHO's was the only one where the spacing wasn't consistent, that would seem a very odd coincidence that might stretch credulity. I strongly suspect, though, that there were other certificates with similar anomalies.