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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000046

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Pauline ElizabethFrancis Sex Female

Date of Birth February 7, 1921 Place of Birth YarmouthCounty of Yarmouth

Name of Father Luke Francis MAIDEN NAME of Mother Vera Elizabeth Bernard

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

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

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

Race African Name and present address of Physician in attendance at birth Dr. G.J. Fuller

Signature of Applicant Mrs. Vera E. Francis Address of Applicant Yarmouth Date October 11, 1946

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Pauline ElizabethFrancis

Born at Yarmouth in the County of Yarmouth

That Pauline ElizabethFrancis Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on February 7, 1921

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

I am the mohter of Pauline Elizabeth Francis

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