Birth ID:                    

Certificate Location:        
Certificate Number:          

Birth Location:              
Birth Date:                  

Name:                        
Immigrant ID:                CRTC-21OCT1915-3-8-0008 
Sex:                         

Parents' Home Address:       

Father's Name:               
Immigrant ID:                STPA-27JUN1903-3-C-0026 SICN-08SEP1903-3-C1-0029 
Birth Place:                 
Occupation:                  

Mother's Name:               
Immigrant ID:                STPA-27JUN1903-3-C-0027 SICN-08SEP1903-3-C1-0030 CRTC-21OCT1915-3-8-0004 
Birth Place:                 
Occupation:                  

No. of Children Born:        
No. of Children Now Living:  

Parents' Marriage Date:      
Parents' Marriage Place:     


Comments:
                             delayed birth, registered 12-Jan-1928 at Brantford, Brant Co., ON