Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Mary Violette Sampson birth West Arichat, Richmond County on October 16, 1921
Female Birth Registration: Year: 1921 number: 60700591
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Registered No. 60700591
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Richmond
City, Town or Village West Arichat
2. FULL NAME OF CHILD Sampson, Mary Violette
3. Sex of child
Female
4. Twin, triplet or other?
5. Was the child born alive?
6. Legitimate?
7. Date of Birth
October 16, 1921
FATHER
8. Full Name Walter Sampson
9. Residence West Arichat
10. Racial Origin French | 11. Age at last birthday
12. Birthplace West Arichat
13. Occupation: —
(a) Trade or profession Pipe-fitter
(b) Business in which employed
MOTHER
14. Full Maiden Name Lily LeBlanc
15. Residence
16. Racial Origin | 17. Age at last birthday
18. Birthplace
19. Number of children of this mother (including this child)
Living Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Walter Sampson Gloucester, Mass.
22. Name of Doctor, nurse or other person in attendance at birth Dr. LeBlanc
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 12 Aug. 1926
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