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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93401242

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Susan GladysMartin Sex Female

Date of Birth January 10, 1906 Place of Birth Lower Ship HarbourCounty of Halifax

Name of Father Charles Lewis Martin MAIDEN NAME of Mother Laura May Eddy

Residence of Father when child was born Lower Ship Harbour Present address of Father Lower Ship Harbour

Occupation of Father at Birth of child Mill hand Place of birth of Father Lower Ship Harbour

Race Irish Name and present address of Physician in attendance at birth Dr. G. Jamison

Signature of Applicant Susan Gladys Martin Address of Applicant Lower Ship Harbour Date 29 January 1926

Relationship of Applicant to child self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Susan GladysMartin

Born at Lower Ship Harbour in the County of Halifax

That Susan GladysMartin Whose Birth is sought to be registered was

born at Lower Ship Harbour Halifax County on January 10, 1906

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

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