Male Birth Registration: Year: 1922 number: 60900024
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Registered No. 60900024
PROVINCE OF NOVA SCOTIA
CERTIFICATE OF REGISTRATION OF BIRTH
1. PLACE OF BIRTH
County of Pictou
City, Town or Village Stellarton
2. FULL NAME OF CHILD Samson, Charles
3. Sex of child
Male
4. Twin, triplet or other?
5. Was the child born alive?
Yes
6. Legitimate?
Yes
7. Date of Birth
October 5, 1922
FATHER
8. Full Name Arthur Leslie Samson
9. Residence Scotch Hill PIctou Co
10. Racial Origin English | 11. Age at last birthday 39
12. Birthplace Woolwick England
13. Occupation: —
(a) Trade or profession Farmer
(b) Business in which employed Farming
MOTHER
14. Full Maiden Name Daisy Jane Sample
15. Residence Scotch Hill Pictou Co
16. Racial Origin Canadian | 17. Age at last birthday 33
18. Birthplace Stewiacke Colchester co
19. Number of children of this mother (including this child)
Living 7 Dead Stillborn
20. Occupation, if other than household duties
21. Name and Post Office address of Informant Scotch Hill Pictou CO
22. Name of Doctor, nurse or other person in attendance at birth Dr. Benvie
I certify the foregoing to be true and correct to the best of my knowledge and belief.
Given under my hand this 18th October 1922
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/birth/?ID=421474
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