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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700484

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary FrancisCoffell Sex Female

Date of Birth February 14, 1922 Place of Birth AmherstCounty of Cumberland

Name of Father Stanley Coffell MAIDEN NAME of Mother Stella Barkhouse

Residence of Father when child was born Present address of Father Amherst, Cumberland Co., NS

Occupation of Father at Birth of child Electrician Place of birth of Father Kingsport, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mary Francis Coffell Address of Applicant Amherst, Cumberland Co., NS Date 22 July 1943

Relationship of Applicant to child Self

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary FrancisCoffell

Born at Amherst in the County of Cumberland

That Mary FrancisCoffell Whose Birth is sought to be registered was

born at Amherst Cumberland County on February 14, 1922

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

I am the father of the above Mary Francis Coffell and was living at home at the time of birth. I remember the date and circumstances very well.

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