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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93300555

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth November 3, 1906 Place of Birth MelbourneCounty of Yarmouth

Name of Father Brandon Smith MAIDEN NAME of Mother Genevieve McGray

Residence of Father when child was born Melbourne Present address of Father Melbourne

Occupation of Father at Birth of child Farmer Place of birth of Father Little River

Race English Name and present address of Physician in attendance at birth Dr. W.S. Phinney

Signature of Applicant Genevieve Smith Address of Applicant Melbourne Date 2 October 1925

Relationship of Applicant to child mother

AFFIDAVIT

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

Born at Melbourne in the County of Yarmouth

That ElsieSmith Whose Birth is sought to be registered was

born at Melbourne Yarmouth County on November 3, 1906

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

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