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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

64500135

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Douglas ReginaldBrown Sex Male

Date of Birth November 7, 1919 Place of Birth SpringhillCounty of Cumberland

Name of Father Laurie Emmerson Brown MAIDEN NAME of Mother Clara May Mills

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

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

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

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

Signature of Applicant Clara May Brown Address of Applicant Springhill Date 13 December 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Douglas ReginaldBrown

Born at Springhill in the County of Cumberland

That Douglas ReginaldBrown Whose Birth is sought to be registered was

born at Springhill Cumberland County on November 7, 1919

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

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