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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700277

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 7, 1919 Place of Birth Pottles LakeCounty of Cape Breton

Name of Father Roderick Andrews MAIDEN NAME of Mother Mildred Woods

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

Residence of Father when child was born Georges River Present address of Father Pottles Lake

Occupation of Father at Birth of child Farmer Place of birth of Father Pottles Lake

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

Signature of Applicant Roderick Andrews Address of Applicant Pottles Lake Date 08 December 1919

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Pottles Lake in the County of Cape Breton

That WilliamAndrews Whose Birth is sought to be registered was

born at Pottles Lake Cape Breton 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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