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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700381

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Viola FrancisRasmussen Sex Female

Date of Birth November 18, 1919 Place of Birth Alder PointCounty of Cape Breton

Name of Father Simon Peter Rasmussen MAIDEN NAME of Mother Sarah May Pan

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

Residence of Father when child was born Alder Point Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Boston, Mass., USA

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

Signature of Applicant Simon Peter Rasmussen Address of Applicant Alder Point Date 20 November 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Viola FrancisRasmussen

Born at Alder Point in the County of Cape Breton

That Viola FrancisRasmussen Whose Birth is sought to be registered was

born at Alder Point Cape Breton County on November 18, 1919

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

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