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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700443

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy JeanClare Sex Female

Date of Birth October 28, 1919 Place of Birth SydneyCounty of Cape Breton

Name of Father Walter C. Clare MAIDEN NAME of Mother Daphne Bickerton

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

Residence of Father when child was born Sydney Present address of Father 36 Pleasnat St.

Occupation of Father at Birth of child Stove mounter Place of birth of Father Sackville, NB

Race Name and present address of Physician in attendance at birth Dr. J.B. Lynch

Signature of Applicant Daphne Clare Address of Applicant 36 Pleasant St. Date 01 November 1919

Relationship of Applicant to child mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy JeanClare

Born at Sydney in the County of Cape Breton

That Dorothy JeanClare Whose Birth is sought to be registered was

born at Sydney Cape Breton County on October 28, 1919

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

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