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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700250

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of DuncanMcDougall Sex Male

Date of Birth December 4, 1919 Place of Birth DominionCounty of Cape Breton

Name of Father John R. McDougall MAIDEN NAME of Mother Mary F. Gillis

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

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

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

Race Name and present address of Physician in attendance at birth Dr. J.A. Ferguson

Signature of Applicant John R. McDougall Address of Applicant Dominion Date 03 January 1920

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Dominion in the County of Cape Breton

That DuncanMcDougall Whose Birth is sought to be registered was

born at Dominion Cape Breton County on December 4, 1919

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

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