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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000823

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Christina EvelynRogers Sex Female

Date of Birth November 22, 1922 Place of Birth ThorburnCounty of Pictou

Name of Father Edward Rogers MAIDEN NAME of Mother Mary Boutilier

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

Residence of Father when child was born Thorburn, Pictou Present address of Father Deceased

Occupation of Father at Birth of child Miner Place of birth of Father New Waterford, Cape Breton

Race Name and present address of Physician in attendance at birth

Signature of Applicant Christina E. Urquhart Address of Applicant 137 North Avenue, New Glasgow, Pictou Date 15 September 1980

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Christina EvelynRogers

Born at Thorburn in the County of Pictou

That Christina EvelynRogers Whose Birth is sought to be registered was

born at Thorburn Pictou County on November 22, 1922

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

Baptismal

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