Female Birth Registration: Year: 1921 number: 99000416
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PROVINCE OF NOVA SCOTIA
DELAYED REGISTRATION OF BIRTH
99000416
TO THE REGISTRAR GENERAL OF NOVA SCOTIA
I hereby make application for the Registration of Birth of Vivian MurielSamuels Sex Female
Date of Birth July 18, 1921 Place of Birth DartmouthCounty of Halifax
Name of Father Wilford Martin Samuels MAIDEN NAME of Mother Edith Priscilla Bauld
Were the Parents married at the time of the Birth? Yes
Residence of Father when child was born Dartmouth Present address of Father deceased
Occupation of Father at Birth of child C.N.R. Porter Place of birth of Father British West Indies
Race Colored Name and present address of Physician in attendance at birth Dr. Dixon
Signature of Applicant Edith A. Sparks Address of Applicant Cherry Brook Date 16 November 1969
Relationship of Applicant to child Mother
AFFIDAVIT
IN THE MATTER of the application for the Registration of the Birth of Vivian MurielSamuels
Born at Dartmouth in the County of Halifax
That Vivian MurielSamuels Whose Birth is sought to be registered was
born at Dartmouth Halifax County on July 18, 1921
My knowledge of the fact and date of such Birth is based on the following Circumstances:
I am her mother
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Note: African Nova Scotian
Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=416809
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