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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93300622

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred FlorenceWagner Sex Female

Date of Birth July 29, 1906 Place of Birth KentvilleCounty of Kings

Name of Father Charles Playfair Wagner MAIDEN NAME of Mother Florence Matilda Hiltz

Residence of Father when child was born Kentville Present address of Father Bricton

Occupation of Father at Birth of child Farmer Place of birth of Father New Canada

Race German Name and present address of Physician in attendance at birth Dr. H.B. Webster

Signature of Applicant Charles Playfair Wagner Address of Applicant Bricton Date 21 November 1925

Relationship of Applicant to child father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred FlorenceWagner

Born at Kentville in the County of Kings

That Mildred FlorenceWagner Whose Birth is sought to be registered was

born at Kentville Kings County on July 29, 1906

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

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