Female Birth Registration: Year: 1921 number: 63100833
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Registered No. 63100833
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Hants
City, Town or Village Mill Village
2. FULL NAME OF CHILD Smith, Hazel Ethel
3. Sex of child
Female
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
March 21, 1921
FATHER
8. Full Name Percy Warren Smith
9. Residence Shubenacadie
10. Racial Origin Scottish | 11. Age at last birthday 28
12. Birthplace Indian Road
13. Occupation: —
(a) Trade or profession Crupper
(b) Business in which employed Lumbering
MOTHER
14. Full Maiden Name Jessie Maude Moore
15. Residence Shubenacadie
16. Racial Origin Irish | 17. Age at last birthday 24
18. Birthplace East Uniacke
19. Number of children of this mother (including this child)
Living 4 Dead 1 Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Percy Smith Shubenacadie
22. Name of Doctor, nurse or other person in attendance at birth Mrs. Arthur Robinson and Dr. McInnis
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 12 April 1921
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=409302
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