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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

93300228

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of CarolineMcKenzie Sex Female

Date of Birth March 16, 1906 Place of Birth CansoCounty of Guysborough

Name of Father Charles Bradford McKenzie MAIDEN NAME of Mother Mary Jessie Ryan

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

Occupation of Father at Birth of child Fisherman Place of birth of Father Canso

Race white Name and present address of Physician in attendance at birth Dr. Hugh Ross

Signature of Applicant Charles Bradford McKenzie Address of Applicant Canso Date 12 October 1925

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of CarolineMcKenzie

Born at Canso in the County of Guysborough

That CarolineMcKenzie Whose Birth is sought to be registered was

born at Canso Guysborough County on March 16, 1906

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

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