Male Birth Registration: Year: 1921 number: 66100266
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Registered No. 66100266
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Cape Breton
City, Town or Village Sydney Mines
2. FULL NAME OF CHILD Kubicek, John Thomas
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
April 25, 1921
FATHER
8. Full Name Frank Kubicek
9. Residence Toms Road Sydney Mines
10. Racial Origin Bohemian | 11. Age at last birthday 41
12. Birthplace Bohemia
13. Occupation: —
(a) Trade or profession Miner
(b) Business in which employed Coal Mining
MOTHER
14. Full Maiden Name Aloysia Helgect
15. Residence Toms Rd. Sydney Mines
16. Racial Origin | 17. Age at last birthday 34
18. Birthplace Bohemia
19. Number of children of this mother (including this child)
Living 9 Dead Stillborn 1
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Frank Kubicek Sydney Mines
22. Name of Doctor, nurse or other person in attendance at birth DW Archibald, M.D.
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 21 April 1921
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=413239
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