Male Birth Registration: Year: 1919 number: 67000036
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Registered No. 67000036
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Annapolis
City, Town or Village Upper Clements
2. FULL NAME OF CHILD Potter, Harold LeRoy Clifford
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
November 27, 1919
FATHER
8. Full Name Ozias Wimburn Potter
9. Residence Upper Clements
10. Racial Origin English | 11. Age at last birthday 33
12. Birthplace Upper Clements
13. Occupation: —
(a) Trade or profession Farmer
(b) Business in which employed
MOTHER
14. Full Maiden Name Margaret Flavilla Potter
15. Residence Upper Clements
16. Racial Origin English | 17. Age at last birthday 23
18. Birthplace St. John, New Brunswick
19. Number of children of this mother (including this child)
Living 2 Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Ozias W. Potter Annapolis Royal
22. Name of Doctor, nurse or other person in attendance at birth Dr. L.B. Braine and Mrs. Albert Rice
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 24 December 1919
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=402293
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