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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700461

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Robert JohnCameron Sex Male

Date of Birth October 21, 1921 Place of Birth FairviewCounty of Halifax

Name of Father Robert John Cameron MAIDEN NAME of Mother Mildred Mary MacDonald

Residence of Father when child was born Fairview, Halifax Co., NS Present address of Father 98 Victoria Road, Halifax, NS

Occupation of Father at Birth of child Service Station Attendant Place of birth of Father Scotland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Mildred Mary Cameron Address of Applicant 27 1/2 Inglis Street, Halifax, NS Date 18 August 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Robert JohnCameron

Born at Fairview in the County of Halifax

That Robert JohnCameron Whose Birth is sought to be registered was

born at Fairview Halifax County on October 21, 1921

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

I am the mother of the said Robert John Cameron.

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