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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200073

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Lawrence EdwardMartell Sex Male

Date of Birth October 14, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Thomas Martell MAIDEN NAME of Mother Mattie Pottie

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

Residence of Father when child was born Halifax Present address of Father 1 1/2 Morris St.

Occupation of Father at Birth of child Place of birth of Father Lardoise, Cape Breton

Race Name and present address of Physician in attendance at birth Harrison

Signature of Applicant Thomas Martell Address of Applicant 1 1/2 Morris St. Date 14 October 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Lawrence EdwardMartell

Born at Halifax in the County of Halifax

That Lawrence EdwardMartell Whose Birth is sought to be registered was

born at Halifax Halifax County on October 14, 1919

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

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