Male Birth Registration: Year: 1921 number: 66100378
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Registered No. 66100378
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Cape Breton
City, Town or Village Sydney
2. FULL NAME OF CHILD David, Jacob Bernard
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
May 5, 1921
FATHER
8. Full Name Simon (Sam) David
9. Residence Sydney, Vic. Rd, No 572
10. Racial Origin Jewish | 11. Age at last birthday 27
12. Birthplace Russia
13. Occupation: —
(a) Trade or profession Merchant
(b) Business in which employed Groceries
MOTHER
14. Full Maiden Name Lilly Mirsky
15. Residence Sydney, Victoria Rd, No 572
16. Racial Origin Jewish | 17. Age at last birthday 27
18. Birthplace Russia
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 W R MacRae Whitney Pier
22. Name of Doctor, nurse or other person in attendance at birth W R MacRae
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 26 April 1921
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Note: Archived Marriage Cert of 1920 has Father's given name as Simon
Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=413351
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