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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000330

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Jean Marjorie PatriciaO'Brien Sex Female

Date of Birth June 22, 1923 Place of Birth HalifaxCounty of Halifax

Name of Father James Henry O'Brien MAIDEN NAME of Mother Thelma Lucilla Heighton

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

Residence of Father when child was born United Fruit Boat Present address of Father England

Occupation of Father at Birth of child Seaman Place of birth of Father Bedford, Halifax Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Thelma O'Brien Address of Applicant 2091 Maynard Street, Halifax, NS Date 12 December 1966

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Jean Marjorie PatriciaO'Brien

Born at Halifax in the County of Halifax

That Jean Marjorie PatriciaO'Brien Whose Birth is sought to be registered was

born at Halifax Halifax County on June 22, 1923

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

The Nurse filled in paper at the time but must of failed to send it in to be registered. I do not remember the name of nurse.

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