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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700522

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Madeline BerniceDavidson Sex Female

Date of Birth October 27, 1921 Place of Birth Lower WolfvilleCounty of Kings

Name of Father Clarence Douglas Davidson MAIDEN NAME of Mother Marguerite Mary Atwell

Residence of Father when child was born Lower Wolfville, Kings Co., NS Present address of Father Boston, Massachusetts, USA

Occupation of Father at Birth of child Labourer Place of birth of Father Gaspereau, Kings Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Marguerite Mary McLaughlin Address of Applicant RR #1, Wolfville, Kings Co., NS Date 21 May 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Madeline BerniceDavidson

Born at Lower Wolfville in the County of Kings

That Madeline BerniceDavidson Whose Birth is sought to be registered was

born at Lower Wolfville Kings County on October 27, 1921

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

I am the mother of the said Madeline Bernice Davidson

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