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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000499

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred RuthAndrews Sex Female

Date of Birth May 9, 1922 Place of Birth DominionCounty of Cape Breton

Name of Father Clarence Soward Andrews MAIDEN NAME of Mother Florence Agnes Gray

Were the Parents married at the time of the Birth? No

Residence of Father when child was born Dominion, Cape Breton Present address of Father 22 Pleasant Street, Dominion, Cape Breton

Occupation of Father at Birth of child Miner Place of birth of Father Gardiner Mines, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mildred Ruth Mills Address of Applicant 2 Wilhelmina Street, Glace Bay, Cape Breton Date 7 December 1973

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred RuthAndrews

Born at Dominion in the County of Cape Breton

That Mildred RuthAndrews Whose Birth is sought to be registered was

born at Dominion Cape Breton County on May 9, 1922

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

I am her mother.

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