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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000065

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John NorbertBroderick Sex Male

Date of Birth November 24, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Louis Thomas Broderick MAIDEN NAME of Mother Gertrude MacDaniel

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

Residence of Father when child was born 3 Victoria Street, Glace Bay, Cape Breton Present address of Father Deceased

Occupation of Father at Birth of child Machinist Place of birth of Father Little Bras d'Or, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant John Norbert Broderick Address of Applicant 3 Victoria Street, Glace Bay, Cape Breton Date 24 June 1948

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John NorbertBroderick

Born at Glace Bay in the County of Cape Breton

That John NorbertBroderick Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on November 24, 1922

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

John Norbert Broderick was born on 24 of November 1922 at St. Joseph Hospital. Physician attending at birth was the late Dr. E. O. McDonald, certificate from Hospital and Church attached.

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