Female Birth Registration: Year: 1922 number: 39000565
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Registered No. 39000565
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Queens
City, Town or Village South West Port Mouton
2. FULL NAME OF CHILD Burgess, Addie Nora
3. Sex of child
Female
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
March 1, 1922
FATHER
8. Full Name John Arthur Burgess
9. Residence S.W. Port Mouton
10. Racial Origin English | 11. Age at last birthday 42
12. Birthplace S.W. Port Mouton
13. Occupation: —
(a) Trade or profession Fishing
(b) Business in which employed
MOTHER
14. Full Maiden Name Effie Mordena Burgess
15. Residence S.W. Port Mouton
16. Racial Origin English | 17. Age at last birthday 42
18. Birthplace S.W. Port Mouton
19. Number of children of this mother (including this child)
Living Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant S.W. Port Mouton, Queens
22. Name of Doctor, nurse or other person in attendance at birth Mrs. Ellen Bowen
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 30 March 1922
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=418187
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