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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000512

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Doris MatildaEmberly Sex Female

Date of Birth November 30, 1923 Place of Birth North SydneyCounty of Cape Breton

Name of Father Patrick Emberly MAIDEN NAME of Mother Beatrice McCarthy

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

Residence of Father when child was born North Sydney Cape Breton Co. Ns Present address of Father Deceased

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant J. White Address of Applicant 44 Windward Avenue, Dartmouth, NS Date 24 February 1975

Relationship of Applicant to child Nephew

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Doris MatildaEmberly

Born at North Sydney in the County of Cape Breton

That Doris MatildaEmberly Whose Birth is sought to be registered was

born at North Sydney Cape Breton County on November 30, 1923

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

Baptismal Certificate

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