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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200286

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Philip GregoryRoche Sex Male

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

Name of Father William J. Roche MAIDEN NAME of Mother Abigail W. Roche

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

Residence of Father when child was born Halifax Present address of Father 3 College St.

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

Race Name and present address of Physician in attendance at birth Dr. F.R. Little

Signature of Applicant William J. Roche Address of Applicant 3 College St. Date 27 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Philip GregoryRoche

Born at Halifax in the County of Halifax

That Philip GregoryRoche Whose Birth is sought to be registered was

born at Halifax Halifax County on November 22, 1919

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

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