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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200247

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas McCullyMacdonald Sex Male

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

Name of Father William Grant Macdonald MAIDEN NAME of Mother Susie Maud Mills

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

Residence of Father when child was born Halifax Present address of Father 102 Inglis St.

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

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

Signature of Applicant William Grant Macdonald Address of Applicant 102 Inglis St. Date 22 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas McCullyMacdonald

Born at Halifax in the County of Halifax

That Douglas McCullyMacdonald Whose Birth is sought to be registered was

born at Halifax Halifax County on November 14, 1919

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

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