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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

41200430

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Hazel EvangelineAlcorn Sex Female

Date of Birth December 19, 1919 Place of Birth HalifaxCounty of Halifax

Name of Father Stairns Royden Alcorn MAIDEN NAME of Mother Daisy Florence Hill

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

Residence of Father when child was born Halifax Present address of Father 11 McCully St.

Occupation of Father at Birth of child Car conductor Place of birth of Father South Boston, USA

Race Name and present address of Physician in attendance at birth P. McDonald

Signature of Applicant Daisy Florence Alcorn Address of Applicant 11 McCully St. Date 07 July 1920

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Hazel EvangelineAlcorn

Born at Halifax in the County of Halifax

That Hazel EvangelineAlcorn Whose Birth is sought to be registered was

born at Halifax Halifax County on December 19, 1919

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

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