Female Birth Registration: Year: 1921 number: 66100488
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Registered No. 66100488
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Cape Breton
City, Town or Village Birch Grove
2. FULL NAME OF CHILD Clark, Margret Louise
3. Sex of child
Female
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
May 6, 1921
FATHER
8. Full Name Bernard Clark
9. Residence Birch Grove, Cape Breton
10. Racial Origin British | 11. Age at last birthday 29
12. Birthplace Victoria, Newfoundland
13. Occupation: —
(a) Trade or profession Miner
(b) Business in which employed Coal Cutting
MOTHER
14. Full Maiden Name Lavina Samson
15. Residence Birch Grove, Cape Breton
16. Racial Origin British | 17. Age at last birthday 26
18. Birthplace Winterton, Trinity Bay, Newfoundland
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 Bernard Clark Birch Grove, Cape Breton
22. Name of Doctor, nurse or other person in attendance at birth Dr. A. K. Roy & Mrs. James Hayes
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 19 May 1921
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=413460
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