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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000842

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Patrick GordonWhite Sex Male

Date of Birth October 31, 1921 Place of Birth Bras d'OrCounty of Cape Breton

Name of Father Henry White MAIDEN NAME of Mother Hattie Laffin

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

Residence of Father when child was born Bras d'Or Present address of Father died

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant P.G. White Address of Applicant 10 Vincienne, Atikokan, Ontario Date April 26, 1978

Relationship of Applicant to child Same

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Patrick GordonWhite

Born at Bras d'Or in the County of Cape Breton

That Patrick GordonWhite Whose Birth is sought to be registered was

born at Bras d'Or Cape Breton County on October 31, 1921

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

Baptism Certificate St. Josephs Parish Bras d'Or N.S.

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