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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

90600975

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Beulah LorenaRoode Sex Female

Date of Birth November 2, 1921 Place of Birth BelmontCounty of Colchester

Name of Father Arthur J. Roode MAIDEN NAME of Mother Emma Laing

Residence of Father when child was born Belmont, Colchester Co., NS Present address of Father Deceased

Occupation of Father at Birth of child Carpenter Place of birth of Father Belmont, Colchester Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Emma Roode Address of Applicant Belmont, Colchester Co., NS Date 17 February 1936

Relationship of Applicant to child Daughter

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Beulah LorenaRoode

Born at Belmont in the County of Colchester

That Beulah LorenaRoode Whose Birth is sought to be registered was

born at Belmont Colchester County on November 2, 1921

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

Being mother of person sought to be registered

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