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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200056

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of DavisLaurine Annie Sex Female

Date of Birth October 11, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Thomas Joseph Davis MAIDEN NAME of Mother Cecilia Norris

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

Residence of Father when child was born Halifax Present address of Father 181 Jubilee Rd

Occupation of Father at Birth of child Optician Place of birth of Father East River

Race Name and present address of Physician in attendance at birth E.K. MacLillan

Signature of Applicant Thomas J. Davis Address of Applicant 181 Jubilee Rd Date 01 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of DavisLaurine Annie

Born at Halifax in the County of Halifax

That DavisLaurine Annie Whose Birth is sought to be registered was

born at Halifax Halifax County on October 11, 1919

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

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