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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700367

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 11, 1919 Place of Birth Mill CreekCounty of Cape Breton

Name of Father David Campbell MAIDEN NAME of Mother Elizabeth Jane Mone

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

Residence of Father when child was born Mill Creek Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Sydney Mines

Race Name and present address of Physician in attendance at birth Dr. William T. McKeough

Signature of Applicant David Campbell Address of Applicant Mill Creek Date 17 November 1919

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Mill Creek in the County of Cape Breton

That AloysiusCampbell Whose Birth is sought to be registered was

born at Mill Creek Cape Breton County on November 11, 1919

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

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