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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000225

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Violet RoseFells Sex Female

Date of Birth May 25, 1923 Place of Birth YarmouthCounty of Yarmouth

Name of Father Roy Morton Fells MAIDEN NAME of Mother Lizzie B. Muise

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

Residence of Father when child was born Yarmouth Ns Present address of Father Yarmouth, NS

Occupation of Father at Birth of child Office Clerk - Grocery Place of birth of Father Yarmouth, NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant R. M. Fells Address of Applicant Yarmouth, NS Date 25 May 1923

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Violet RoseFells

Born at Yarmouth in the County of Yarmouth

That Violet RoseFells Whose Birth is sought to be registered was

born at Yarmouth Yarmouth County on May 25, 1923

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

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