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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700195

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean Marjorie PatriciaO'Brien Sex Female

Date of Birth June 22, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father James Henry O'Brien MAIDEN NAME of Mother Thelma Lucilla Creighton

Residence of Father when child was born At Sea Present address of Father At Sea

Occupation of Father at Birth of child Seaman Place of birth of Father Bedford, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Thelma Lucille O'Brien Address of Applicant 151 Argyle Street, Halifax, NS Date 27 January 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean Marjorie PatriciaO'Brien

Born at Halifax in the County of Halifax

That Jean Marjorie PatriciaO'Brien Whose Birth is sought to be registered was

born at Halifax Halifax County on June 22, 1923

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

I am her mother and have knowledge of the facts stated above

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