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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000004

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Bertha MildredMiller Sex Female

Date of Birth January 31, 1920 Place of Birth Eden LakeCounty of Pictou

Name of Father Daniel Miller MAIDEN NAME of Mother Catherine Wood

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

Residence of Father when child was born Eden Lake Present address of Father Eden Lake

Occupation of Father at Birth of child Farmer Place of birth of Father Eden Lake

Race Scottish Name and present address of Physician in attendance at birth Dr. F.B. Day, Thorburn

Signature of Applicant Bertha Mildred Miller Address of Applicant Eden Lake Date August 24, 1946

Relationship of Applicant to child

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Bertha MildredMiller

Born at Eden Lake in the County of Pictou

That Bertha MildredMiller Whose Birth is sought to be registered was

born at Eden Lake Pictou County on January 31, 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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