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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700307

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Maria JosephaCampbell Sex Female

Date of Birth November 6, 1919 Place of Birth Glace BayCounty of Cape Breton

Name of Father Peter Campbell MAIDEN NAME of Mother Agatha Butler

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

Residence of Father when child was born Glace Bay Present address of Father King Edward St.

Occupation of Father at Birth of child Car repairer [mechanic] Place of birth of Father Mauradian, Cape Breton

Race Name and present address of Physician in attendance at birth Mrs. Walter Grant, nurse

Signature of Applicant Peter Campbell Address of Applicant King Edward St., Glace Bay Date 26 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Maria JosephaCampbell

Born at Glace Bay in the County of Cape Breton

That Maria JosephaCampbell Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on November 6, 1919

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

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