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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500105

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Helen JaneWood Sex Female

Date of Birth November 5, 1919 Place of Birth ShinimicasCounty of Cumberland

Name of Father John Henry Wood MAIDEN NAME of Mother Annie R Smith

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

Residence of Father when child was born Shiminicas Present address of Father

Occupation of Father at Birth of child Farmer Place of birth of Father Cumberland Co.

Race Name and present address of Physician in attendance at birth Dr. E.P. Henison

Signature of Applicant John Henry Wood Address of Applicant Shiminicas Date 10 January 1920

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Helen JaneWood

Born at Shinimicas in the County of Cumberland

That Helen JaneWood Whose Birth is sought to be registered was

born at Shinimicas Cumberland County on November 5, 1919

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

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