Female Birth Registration: Year: 1921 number: 66100102
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Registered No. 66100102
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Cape Breton
City, Town or Village Glace Bay
2. FULL NAME OF CHILD Boutilier, Jean Bernice
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 6, 1921
FATHER
8. Full Name Louis Boutilier
9. Residence Caledonia Mines
10. Racial Origin English | 11. Age at last birthday 28
12. Birthplace Glace Bay
13. Occupation: —
(a) Trade or profession Merchant
(b) Business in which employed Grocery
MOTHER
14. Full Maiden Name Katie Clementine Stubbert
15. Residence Caledonia Mines
16. Racial Origin English | 17. Age at last birthday 28
18. Birthplace Reserve Mines
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 Louis Boutilier Caledonia Mines
22. Name of Doctor, nurse or other person in attendance at birth Dr. F.W. Green & Rachel Boutilier
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 21 March 1921
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=413077
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