Female Birth Registration: Year: 1920 number: 99000971
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PROVINCE OF NOVA SCOTIA
DELAYED REGISTRATION OF BIRTH
99000971
TO THE REGISTRAR GENERAL OF NOVA SCOTIA
I hereby make application for the Registration of Birth of Mary JovitaSampson Sex Female
Date of Birth September 8, 1920 Place of Birth SydneyCounty of Cape Breton
Name of Father Albert Sampson MAIDEN NAME of Mother Bertha McDonald
Were the Parents married at the time of the Birth? Yes
Residence of Father when child was born Sydney Present address of Father deceased
Occupation of Father at Birth of child Taxi Business Place of birth of Father L'Ardoise
Race Name and present address of Physician in attendance at birth
Signature of Applicant Mary McGuire Address of Applicant Sydney Date Februart 28, 1979
Relationship of Applicant to child self
AFFIDAVIT
IN THE MATTER of the application for the Registration of the Birth of Mary JovitaSampson
Born at Sydney in the County of Cape Breton
That Mary JovitaSampson Whose Birth is sought to be registered was
born at Sydney Cape Breton County on September 8, 1920
My knowledge of the fact and date of such Birth is based on the following Circumstances:
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=398653
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