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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700397

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of AgnesYoung Sex Female

Date of Birth November 18, 1919 Place of Birth DominionCounty of Cape Breton

Name of Father John Young MAIDEN NAME of Mother Bessie Manger

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 Bridgeport

Race Name and present address of Physician in attendance at birth Martha McPherson

Signature of Applicant John Young Address of Applicant Dominion Date 22 November 1919

Relationship of Applicant to child father

AFFIDAVIT

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

Born at Dominion in the County of Cape Breton

That AgnesYoung Whose Birth is sought to be registered was

born at Dominion 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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