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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000223

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Anna GrahamForbes Sex Female

Date of Birth May 25, 1922 Place of Birth Glace BayCounty of Cape Breton

Name of Father Archibald Graham Forbes MAIDEN NAME of Mother Marguerite Kennedy

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

Residence of Father when child was born Glace Bay, Cape Breton Present address of Father Glace Bay, Cape Breton

Occupation of Father at Birth of child Mechanic Place of birth of Father North Sydney, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Anna Graham Forbes Address of Applicant Glace Bay, Cape Breton Date 9 September 1957

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Anna GrahamForbes

Born at Glace Bay in the County of Cape Breton

That Anna GrahamForbes Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 25, 1922

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

It is the date shown on the extract from Hospital records, Glace Bay General Hospital, attached herewith

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