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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800242

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean HenriettaHart Sex Female

Date of Birth March 21, 1923 Place of Birth SydneyCounty of Cape Breton

Name of Father   MAIDEN NAME of Mother Marion Hart

Residence of Father when child was born Present address of Father

Occupation of Father at Birth of child Place of birth of Father

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. M. Philpott Address of Applicant 314 Sumach Street, Toronto, Ontario Date 27 August 1944

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean HenriettaHart

Born at Sydney in the County of Cape Breton

That Jean HenriettaHart Whose Birth is sought to be registered was

born at Sydney Cape Breton County on March 21, 1923

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

She was born in City Hospital by me.

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