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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000109

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth July 25, 1921 Place of Birth South OhioCounty of Yarmouth

Name of Father Archie Cann Cook MAIDEN NAME of Mother Helen May Crosby

Residence of Father when child was born South Ohio Present address of Father deceased

Occupation of Father at Birth of child Pattern maker Place of birth of Father South Ohio

Race English Name and present address of Physician in attendance at birth Dr. Z. Hawkins

Signature of Applicant Mrs. Mildred Porter Address of Applicant Yarmouth Date May 10, 1949

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at South Ohio in the County of Yarmouth

That Mildred EudoraCook Whose Birth is sought to be registered was

born at South Ohio Yarmouth County on July 25, 1921

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

My knowledge of my Birth is taken fromt he Family Bible. I also have a statement fromt he Dr. in attendance. I have examined the Family Bible and find the date corresponds with the date given above. The record in the Family Bible has every indication of having been recorded at the time of the birth.

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