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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700074

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth December 28, 1919 Place of Birth Little Bras D'OrCounty of Cape Breton

Name of Father William Hines MAIDEN NAME of Mother Mary Alexander

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

Residence of Father when child was born Little Bras d'Or Present address of Father Gannon Rd.

Occupation of Father at Birth of child Coal miner Place of birth of Father Nova Scotia

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

Signature of Applicant William Hines Address of Applicant Gannon Rd., Little Bras d'Or Date 30 January 1920

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Little Bras D'Or in the County of Cape Breton

That MaryHines Whose Birth is sought to be registered was

born at Little Bras D'Or Cape Breton County on December 28, 1919

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

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