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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200029

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Thelma RuthHines Sex Female

Date of Birth October 7, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Isaac Hines MAIDEN NAME of Mother Rose Salsman

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

Residence of Father when child was born Halifax Present address of Father 208 Agricola St.

Occupation of Father at Birth of child Driver Place of birth of Father Newfoundland

Race Name and present address of Physician in attendance at birth Dr. Finlay

Signature of Applicant Address of Applicant 208 Agricola St. Date 25 October 1919

Relationship of Applicant to child parents

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Thelma RuthHines

Born at Halifax in the County of Halifax

That Thelma RuthHines Whose Birth is sought to be registered was

born at Halifax Halifax County on October 7, 1919

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

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