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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

91900432

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Joycelyn AlliceRourke Sex Female

Date of Birth April 26, 1923 Place of Birth New GlasgowCounty of Pictou

Name of Father John Alexander Rourke MAIDEN NAME of Mother Lottie Lavinia Boutilier

Residence of Father when child was born New Glasgow, Pictou Co., NS Present address of Father New Glasgow, Pictou Co., NS

Occupation of Father at Birth of child Salesman Place of birth of Father Halifax, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Lottie L. Rourke Address of Applicant New Glasgow, Pictou Co., NS Date 13 February 1945

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Joycelyn AlliceRourke

Born at New Glasgow in the County of Pictou

That Joycelyn AlliceRourke Whose Birth is sought to be registered was

born at New Glasgow Pictou County on April 26, 1923

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

I am her mother

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