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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91700723

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Pearl Gwendline BlackmoreLong Sex Female

Date of Birth May 12, 1922 Place of Birth HalifaxCounty of Halifax

Name of Father Edmund Long MAIDEN NAME of Mother Daisy Knee Blackmore

Residence of Father when child was born Woodside, Halifax Co., NS Present address of Father St. John's, Newfoundland

Occupation of Father at Birth of child Painter Place of birth of Father Champneys West, Trinity Bay, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Daisy Knee Long Address of Applicant 72 Munroe Street, St. John's, Newfoundland Date 8 February 1943

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Pearl Gwendline BlackmoreLong

Born at Halifax in the County of Halifax

That Pearl Gwendline BlackmoreLong Whose Birth is sought to be registered was

born at Halifax Halifax County on May 12, 1922

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

Certificate from Dr. Burris, physician in attendance at time of birth and I am the mother of pearl Gwendline Blackmore

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