Male Birth Registration: Year: 1920 number: 64900501
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Registered No. 64900501
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Colchester
City, Town or Village Shubenacadie
2. FULL NAME OF CHILD Lively, Harry
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
7. Date of Birth
June 24, 1920
FATHER
8. Full Name Samuel Anson Lively
9. Residence Shubenacadie
10. Racial Origin English | 11. Age at last birthday 32
12. Birthplace Beaver Bank, Hants Co. N.S.
13. Occupation: —
(a) Trade or profession Laborer
(b) Business in which employed
MOTHER
14. Full Maiden Name Willena Elliott
15. Residence Shubenacadie
16. Racial Origin English | 17. Age at last birthday 25
18. Birthplace Colstream, Col. Co. N.S.
19. Number of children of this mother (including this child)
Living 2 Dead 1 Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Samuel Anson Lively Shubenacadie, Hants Co.
22. Name of Doctor, nurse or other person in attendance at birth Dr. H.B. Haney
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 19 July 1920
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