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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200422

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ralph GeraldHart Sex Male

Date of Birth December 18, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father John Alfred Hart MAIDEN NAME of Mother Catherine Mabel Cooke

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 Steam engineer Place of birth of Father Guysborough

Race Name and present address of Physician in attendance at birth Mrs. William A. Cook

Signature of Applicant John Alfred Hart Address of Applicant Halifax Date 29 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ralph GeraldHart

Born at Halifax in the County of Halifax

That Ralph GeraldHart Whose Birth is sought to be registered was

born at Halifax Halifax County on December 18, 1919

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

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