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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200113

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Maria FrancesKervin Sex Female

Date of Birth October 22, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Maria Frances Kervin MAIDEN NAME of Mother Gertrude Elizabeth Bliss

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

Residence of Father when child was born Halifax Present address of Father 3B St. John Ave.

Occupation of Father at Birth of child Teamster Place of birth of Father Halifax

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

Signature of Applicant Gertrude Kervin Address of Applicant Halifax Date 13 November 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Maria FrancesKervin

Born at Halifax in the County of Halifax

That Maria FrancesKervin Whose Birth is sought to be registered was

born at Halifax Halifax County on October 22, 1919

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

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