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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200087

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of George DouglasWoodworth Sex Male

Date of Birth October 16, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Breton Charles Woodworth MAIDEN NAME of Mother Margaret Catherine Woodworth

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

Residence of Father when child was born Halifax Present address of Father 119 Jubilee Rd.

Occupation of Father at Birth of child Tea Manager at Wholesale Teas Place of birth of Father Halifax

Race Name and present address of Physician in attendance at birth Dr. A.J. Muder

Signature of Applicant Brenton Charles Woodworth Address of Applicant 119 Jubilee Rd Date 17 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of George DouglasWoodworth

Born at Halifax in the County of Halifax

That George DouglasWoodworth Whose Birth is sought to be registered was

born at Halifax Halifax County on October 16, 1919

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

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