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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000209

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Phyllis JeanRogers Sex Female

Date of Birth April 2, 1920 Place of Birth WindsorCounty of Hants

Name of Father William Rozee Rogers MAIDEN NAME of Mother Elizabeth Evangeline Burrows

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

Residence of Father when child was born Windsor Present address of Father Yarmouth

Occupation of Father at Birth of child Auto Mechanic Place of birth of Father Yarmouth

Race English Name and present address of Physician in attendance at birth Dr. Reid deceased

Signature of Applicant Phyllis Jean Patten Address of Applicant Yarmouth Date August 19, 1953

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Phyllis JeanRogers

Born at Windsor in the County of Hants

That Phyllis JeanRogers Whose Birth is sought to be registered was

born at Windsor Hants County on April 2, 1920

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

My knowledge of my birth is taken from the Census Records and National Registration Record. (+ school record).

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