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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500058

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Silas AlbertRose Sex Male

Date of Birth October 1, 1919 Place of Birth SpringhillCounty of Cumberland

Name of Father   MAIDEN NAME of Mother Florence Rose

Residence of Father when child was born Present address of Father

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

Race Name and present address of Physician in attendance at birth Dr. M.J. Wardrope

Signature of Applicant Florence Rose Address of Applicant 79 Henitt Rd., Springhill Date 18 October 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Silas AlbertRose

Born at Springhill in the County of Cumberland

That Silas AlbertRose Whose Birth is sought to be registered was

born at Springhill Cumberland County on October 1, 1919

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

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