Male Birth Registration: Year: 1921 number: 40600914
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Registered No. 40600914
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Halifax
City, Town or Village Halifax
2. FULL NAME OF CHILD Burgoyne, Fred Elair
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 29, 1921
FATHER
8. Full Name Fred Burgoyne
9. Residence Morris St., Halifax
10. Racial Origin French | 11. Age at last birthday 47
12. Birthplace Vanburan, Maine
13. Occupation: —
(a) Trade or profession News Agent
(b) Business in which employed
MOTHER
14. Full Maiden Name Owna Glenham
15. Residence Morris St. Halifax
16. Racial Origin English | 17. Age at last birthday 24
18. Birthplace Olympia, Washington
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 Fred Burgoyne Westminster Apt Halifax
22. Name of Doctor, nurse or other person in attendance at birth J. R. Conston M.D.
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 1 December 1921
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=403912
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