Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
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Birth Registration:
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Registered No.
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of
City, Town or Village
2. FULL NAME OF CHILD ,
3. Sex of child
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
,
FATHER
8. Full Name John Jones
9. Residence Cooke Street
10. Racial Origin English | 11. Age at last birthday 28
12. Birthplace Lancashire, England
13. Occupation: —
(a) Trade or profession Steelworker
(b) Business in which employed
MOTHER
14. Full Maiden Name Lillian Foster
15. Residence Sydney Mines
16. Racial Origin English | 17. Age at last birthday 24
18. Birthplace Lancashire, England
19. Number of children of this mother (including this child)
Living 1 Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant John Jones Box 461, Sydney Mines
22. Name of Doctor, nurse or other person in attendance at birth Dr. L.W. Johnstone
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 18 September 1920
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Note: duplicate