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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

92800301

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jessie EvelynLangille Sex Female

Date of Birth March 22, 1921 Place of Birth West Branch River JohnCounty of Pictou

Name of Father Victor Alfred Langille MAIDEN NAME of Mother Christena Murray

Residence of Father when child was born West Branch River John, Pictou Co., NS Present address of Father West Branch River John, Pictou Co., NS

Occupation of Father at Birth of child Farmer Place of birth of Father Plainfield, Pictou Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Victor A. Langille Address of Applicant West Branch River John, Pictou Co., NS Date 25 August 1944

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jessie EvelynLangille

Born at West Branch River John in the County of Pictou

That Jessie EvelynLangille Whose Birth is sought to be registered was

born at West Branch River John Pictou County on March 22, 1921

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

I am the father of Jessie Evelyn Langille and was home when she was born.

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