Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Samuel Evans birth Glace Bay, Cape Breton County on August 3, 1921
Male Birth Registration: Year: 1921 number: 66200007
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Registered No. 66200007
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 Evans, Samuel
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
August 3, 1921
FATHER
8. Full Name Alter Evans
9. Residence Glace Bay
10. Racial Origin Russian | 11. Age at last birthday 33
12. Birthplace Russia
13. Occupation: —
(a) Trade or profession Tailor
(b) Business in which employed
MOTHER
14. Full Maiden Name Dora Fireman
15. Residence Glace Bay
16. Racial Origin Austrian | 17. Age at last birthday 29
18. Birthplace Austria
19. Number of children of this mother (including this child)
Living 4 Dead 1 Stillborn 1
20. Occupation, if other than household duties Store Keeper
21. Name and Post Office address of Informant
22. Name of Doctor, nurse or other person in attendance at birth Mrs. L. Octeheverry
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 4 August 1921
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