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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91703548

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris EllenDunsworth Sex

Date of Birth May 17, 1920 Place of Birth DartmouthCounty of Halifax

Name of Father William Dunsworth MAIDEN NAME of Mother Amelia Hiscock

Residence of Father when child was born Prince Street, Dartmouth Present address of Father deceased

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

Race British Name and present address of Physician in attendance at birth Dr. Byrne, Dartmouth (Deceased)

Signature of Applicant Amelia Dunsworth Address of Applicant 41 Philip Street, Halifax Date Novemeber 29, 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris EllenDunsworth

Born at Dartmouth in the County of Halifax

That Doris EllenDunsworth Whose Birth is sought to be registered was

born at Dartmouth Halifax County on May 17, 1920

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

I am her mother

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