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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600258

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Audrey CharlotteChisholm Sex Female

Date of Birth February 23, 1920 Place of Birth HalifaxCounty of Halifax

Name of Father   MAIDEN NAME of Mother Madeline Victoria Chisholm

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race White Name and present address of Physician in attendance at birth Dr. F. R. Little

Signature of Applicant F. R. Little, M. D. Address of Applicant Halifax Date 18 August 1934

Relationship of Applicant to child Doctor in attendance

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Audrey CharlotteChisholm

Born at Halifax in the County of Halifax

That Audrey CharlotteChisholm Whose Birth is sought to be registered was

born at Halifax Halifax County on February 23, 1920

My knowledge of the fact and date of such Birth is based on the following Circumstances:

I was the doctor in attendance

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