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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900838

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Marion AgnesMoses Sex Female

Date of Birth October 20, 1920 Place of Birth South OhioCounty of Yarmouth

Name of Father Freeman Robert Moses MAIDEN NAME of Mother Martha Ellen Vickery

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born South Ohio Present address of Father Argyle Street, Yarmouth

Occupation of Father at Birth of child Butcher Place of birth of Father South Ohio

Race English Name and present address of Physician in attendance at birth Dr. Z. Hawkins

Signature of Applicant Martha E. Moses Address of Applicant Yarmouth Date October 13, 1945

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Marion AgnesMoses

Born at South Ohio in the County of Yarmouth

That Marion AgnesMoses Whose Birth is sought to be registered was

born at South Ohio Yarmouth County on October 20, 1920

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

Mother of child

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