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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700061

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Loretta FrancesHicks Sex Female

Date of Birth December 1, 1919 Place of Birth North SydneyCounty of Cape Breton

Name of Father Thomas Hicks MAIDEN NAME of Mother Rita Boutilier

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

Residence of Father when child was born North Sydney Present address of Father Gannon St.

Occupation of Father at Birth of child Coal miner Place of birth of Father Newfoundland

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

Signature of Applicant Rita Hicks Address of Applicant Gannon St., North Sydney Date 22 December 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Loretta FrancesHicks

Born at North Sydney in the County of Cape Breton

That Loretta FrancesHicks Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on December 1, 1919

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

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