My great-grandparents are in the upper left. My grandparents are in the lower right with my two aunts in front of them. The couple in the middle is my grandfather's brother and his wife. The others are children of the three couples including several my grandfather's brothers and sisters.
According to my 95 year old Aunt Ida, this photo was taken by a "traveling" photographer. It was common at that time to hang an assortment of quilts as a background. This photo was taken on the family farm in rural Kentucky.