Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Elizebeth Loan Sample birth New Glasgow, Pictou County on January 7, 1921
Female Birth Registration: Year: 1921 number: 61400221
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Registered No. 61400221
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Pictou
City, Town or Village New Glasgow
2. FULL NAME OF CHILD Sample, Elizebeth Loan
3. Sex of child
Female
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
January 7, 1921
FATHER
8. Full Name James Edward Sample
9. Residence Stellarton
10. Racial Origin Scottish | 11. Age at last birthday 38
12. Birthplace Stewiacke
13. Occupation: —
(a) Trade or profession Miner
(b) Business in which employed
MOTHER
14. Full Maiden Name Lily Maude Sample
15. Residence New Glasgow
16. Racial Origin English | 17. Age at last birthday 21
18. Birthplace Charlottetown, Prince Edward Island
19. Number of children of this mother (including this child)
Living 1 Dead 2 Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant James Edward Sample
22. Name of Doctor, nurse or other person in attendance at birth dr J C Ballem
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 3 February 1921
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