Male Birth Registration: Year: 1921 number: 67000600
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Registered No. 67000600
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Annapolis
City, Town or Village Clementsvale
2. FULL NAME OF CHILD Potter, Loran Wilfred
3. Sex of child
Male
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 Arthur Churchill Potter
9. Residence Clementsvale
10. Racial Origin English | 11. Age at last birthday 23
12. Birthplace Clementsvale
13. Occupation: —
(a) Trade or profession Farmer
(b) Business in which employed
MOTHER
14. Full Maiden Name Florence Gladys Early
15. Residence Clementsvale
16. Racial Origin English | 17. Age at last birthday 22
18. Birthplace Northfield
19. Number of children of this mother (including this child)
Living 2 Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Arthur C. Potter Clementsvale
22. Name of Doctor, nurse or other person in attendance at birth J.D. Dinsmore Mrs. Aber B. Potter
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 25 March 1921
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=415239
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