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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600287

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Ida JeanMitchell Sex Female

Date of Birth July 31, 1921 Place of Birth DartmouthCounty of Halifax

Name of Father Percy Holloway Mitchell MAIDEN NAME of Mother Maybel Evelyn Merlin

Residence of Father when child was born Dartmouth, Halifax Co., NS Present address of Father Dartmouth, Halifax Co., NS

Occupation of Father at Birth of child Clerk Place of birth of Father Jeddore, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant P. H. Mitchell Address of Applicant Dartmouth, Halifax Co., NS Date 12 December 1934

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Ida JeanMitchell

Born at Dartmouth in the County of Halifax

That Ida JeanMitchell Whose Birth is sought to be registered was

born at Dartmouth Halifax County on July 31, 1921

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

I am her father

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