Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Elizabeth Hollis Sample birth Stellarton, Pictou County on June 27, 1921
Female Birth Registration: Year: 1921 number: 61100222
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Registered No. 61100222
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Pictou
City, Town or Village Stellarton
2. FULL NAME OF CHILD Sample, Elizabeth Hollis
3. Sex of child
Female
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
June 27, 1921
FATHER
8. Full Name Robert H. Sample
9. Residence Stellarton
10. Racial Origin Scottish | 11. Age at last birthday 33
12. Birthplace Stellarton
13. Occupation: —
(a) Trade or profession Coal Miner
(b) Business in which employed
MOTHER
14. Full Maiden Name May McEachern
15. Residence Stellarton
16. Racial Origin Scottish | 17. Age at last birthday 21
18. Birthplace Bridgeville
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 Mrs. R.H. Sample Stellarton
22. Name of Doctor, nurse or other person in attendance at birth R.M. Benni and Mrs. George Osborne
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 28 June 1921
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