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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000089

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Dorothy IsabelDickson Sex Female

Date of Birth June 25, 1921 Place of Birth SydneyCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Mary Catherine Dickson

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 White Name and present address of Physician in attendance at birth Dr. Walsh

Signature of Applicant Mary Catherine Whalen Address of Applicant Sydney Date May 18, 1948

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Dorothy IsabelDickson

Born at Sydney in the County of Cape Breton

That Dorothy IsabelDickson Whose Birth is sought to be registered was

born at Sydney Cape Breton County on June 25, 1921

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

I am her Mother

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