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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200132

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary Margaret AloxineTheriault Sex Female

Date of Birth October 24, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Harry Theriault MAIDEN NAME of Mother Mary Elizabeth Dugnoy

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

Residence of Father when child was born Halifax Present address of Father

Occupation of Father at Birth of child Carpenter Place of birth of Father Quebec

Race Name and present address of Physician in attendance at birth G. McIntosh

Signature of Applicant Harry Theriault Address of Applicant Date 29 October 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary Margaret AloxineTheriault

Born at Halifax in the County of Halifax

That Mary Margaret AloxineTheriault Whose Birth is sought to be registered was

born at Halifax Halifax County on October 24, 1919

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

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