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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

66700599

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Charles RossBuchanan Sex Male

Date of Birth October 25, 1919 Place of Birth DominionCounty of Cape Breton

Name of Father Daniel Buchanan MAIDEN NAME of Mother Mary Wilson

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

Residence of Father when child was born Dominion No. 6 Present address of Father

Occupation of Father at Birth of child Miner Place of birth of Father Big Glace Bay

Race Name and present address of Physician in attendance at birth Dr. J.A. Ferguson

Signature of Applicant Daniel Buchanan Address of Applicant Dominion No. 6 Date 30 October 1919

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Charles RossBuchanan

Born at Dominion in the County of Cape Breton

That Charles RossBuchanan Whose Birth is sought to be registered was

born at Dominion Cape Breton County on October 25, 1919

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

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