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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700146

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of John FrederickMcMahon Sex Male

Date of Birth July 27, 1923 Place of Birth St. Joseph's Hospital, Glace BayCounty of Cape Breton

Name of Father Patrick McMahon MAIDEN NAME of Mother Ethel Hines

Residence of Father when child was born Sydney River, Cape Breton Co., NS Present address of Father Sydney River, Cape Breton Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Scotland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Patrick McMahon Address of Applicant Sydney River, Cape Breton Co., NS Date 1 June 1942

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of John FrederickMcMahon

Born at St. Joseph's Hospital, Glace Bay in the County of Cape Breton

That John FrederickMcMahon Whose Birth is sought to be registered was

born at St. Joseph's Hospital, Glace Bay Cape Breton County on July 27, 1923

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

I am his mother

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