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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500119

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of RiverWood Sex Female

Date of Birth November 15, 1919 Place of Birth River HebertCounty of Cumberland

Name of Father Burton Wood MAIDEN NAME of Mother Evangeline Rosehard

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

Residence of Father when child was born River Hebert Present address of Father

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

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

Signature of Applicant Burton Wood Address of Applicant River Hebert Date 20 December 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of RiverWood

Born at River Hebert in the County of Cumberland

That RiverWood Whose Birth is sought to be registered was

born at River Hebert Cumberland County on November 15, 1919

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

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