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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93602273

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary ElizabethSmith Sex Female

Date of Birth November 18, 1906 Place of Birth PiedmontCounty of Pictou

Name of Father   MAIDEN NAME of Mother Catherine Smith

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Canadian Name and present address of Physician in attendance at birth Dr. Ross

Signature of Applicant William Henry MacDonald Address of Applicant Merigomish Date 20 May 1926

Relationship of Applicant to child father by adoption

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary ElizabethSmith

Born at Piedmont in the County of Pictou

That Mary ElizabethSmith Whose Birth is sought to be registered was

born at Piedmont Pictou County on November 18, 1906

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

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