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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000766

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ella LouiseBoutilier Sex Female

Date of Birth February 3, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father William Boutilier MAIDEN NAME of Mother Madelene Barrett

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

Residence of Father when child was born Cobequid Rd. Halifax Present address of Father deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Ella Louise Fisher Address of Applicant 195 St. Julian St. London, Ontario Date August 17, 1978

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ella LouiseBoutilier

Born at Halifax in the County of Halifax

That Ella LouiseBoutilier Whose Birth is sought to be registered was

born at Halifax Halifax County on February 3, 1921

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

Baptism Certificate

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