Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Fulton Harold Lake birth Upper Burlington, Hants County on January 5, 1921
Male Birth Registration: Year: 1921 number: 63100695
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Registered No. 63100695
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Hants
City, Town or Village Upper Burlington
2. FULL NAME OF CHILD Lake, Fulton Harold
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
January 5, 1921
FATHER
8. Full Name Wilbert Orland Lake
9. Residence Upper Burlington
10. Racial Origin English | 11. Age at last birthday 38
12. Birthplace Center Burlington
13. Occupation: —
(a) Trade or profession Farmer
(b) Business in which employed Farming
MOTHER
14. Full Maiden Name Blanche Rachel Brown
15. Residence Upper Burlington
16. Racial Origin English | 17. Age at last birthday 28
18. Birthplace Upper Burlington
19. Number of children of this mother (including this child)
Living 4 Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Mrs. Wilbert Lake Upper Burlington
22. Name of Doctor, nurse or other person in attendance at birth Dr. A. Reid, Mrs. Annie Brown
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 9 February 1921
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