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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000040

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 4, 1920 Place of Birth New GlasgowCounty of Pictou

Name of Father William Harris Ratchford Fulmer MAIDEN NAME of Mother Gladys Mable Brown

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

Residence of Father when child was born New Glasgow Present address of Father desceased

Occupation of Father at Birth of child Teamster Place of birth of Father Five Islands

Race White Name and present address of Physician in attendance at birth Dr. J.C. Ballem, New Glasgow

Signature of Applicant Marion F. Fulmer Address of Applicant 283 Marsh St. New Glasgow Date April 15, 1946

Relationship of Applicant to child

AFFIDAVIT

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

Born at New Glasgow in the County of Pictou

That Marion FrancesFulmer Whose Birth is sought to be registered was

born at New Glasgow Pictou County on July 4, 1920

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

I was the attending physician at the birth of Marion Frances Fulmer verified by my records

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