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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000041

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Eoin RobertDouglas Sex Male

Date of Birth September 12, 1923 Place of Birth MillsvilleCounty of Pictou

Name of Father John W. Douglas MAIDEN NAME of Mother Etta Elizabeth Rae

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born Millsville Pictou Co. Ns Present address of Father Rogers Hill Centre, Pictou Co., NS

Occupation of Father at Birth of child Sawyer (one who saws wood) Place of birth of Father Lairg, Pictou Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. John W. Douglas Address of Applicant Rogers Hill Centre, Pictou Co., NS Date 21 January 1947

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Eoin RobertDouglas

Born at Millsville in the County of Pictou

That Eoin RobertDouglas Whose Birth is sought to be registered was

born at Millsville Pictou County on September 12, 1923

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

I am his mother. Dr. M. R. Young, Pictou, NS was the physician at birth. Eoin Douglas was baptized at Scotsburn Bethel Church and his baptism record is in the church books.

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