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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200377

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Carl NelsonEisan Sex Male

Date of Birth December 10, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Norman Henry Eisan MAIDEN NAME of Mother Almina Ellen Eisan

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

Residence of Father when child was born Halifax Present address of Father 16B Chatham Ave.

Occupation of Father at Birth of child Lumberman Place of birth of Father Ship Harbour

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

Signature of Applicant Norman Eisan Address of Applicant 16B Chatham Ave. Date 27 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Carl NelsonEisan

Born at Halifax in the County of Halifax

That Carl NelsonEisan Whose Birth is sought to be registered was

born at Halifax Halifax County on December 10, 1919

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

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