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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000071

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Campbell BurstallMacLeod Sex Male

Date of Birth October 12, 1922 Place of Birth New GlasgowCounty of Pictou

Name of Father Hugh Roy MacLeod MAIDEN NAME of Mother Mary Catherine Murray

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

Residence of Father when child was born New Glasgow, Pictou Present address of Father New Glasgow, Pictou

Occupation of Father at Birth of child Bookkeeper Place of birth of Father River John, Pictou

Race Name and present address of Physician in attendance at birth

Signature of Applicant H. R. MacLeod Address of Applicant 325 Abercrombie Road, New Glasgow, Pictou Date 25 June 1948

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Campbell BurstallMacLeod

Born at New Glasgow in the County of Pictou

That Campbell BurstallMacLeod Whose Birth is sought to be registered was

born at New Glasgow Pictou County on October 12, 1922

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

I am the father of Campbell Burstall MacLeod and was at home on October 12th, 1922, the date of his birth.

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