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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000614

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of RoseleenGouthro Sex Female

Date of Birth October 22, 1923 Place of Birth Glace BayCounty of Cape Breton

Name of Father Joseph S. Gouthro MAIDEN NAME of Mother Jane Bates

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

Residence of Father when child was born Glace Bay Cape Breton Co. Ns Present address of Father Glace Bay, Cape Breton Co., NS

Occupation of Father at Birth of child Miner Place of birth of Father Glace Bay, Cape Breton Co., NS

Race Name and present address of Physician in attendance at birth

Signature of Applicant Joseph S. Gouthro Address of Applicant Dominion #11, Glace Bay, Cape Breton Co., NS Date 26 September 1931

Relationship of Applicant to child Father

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of RoseleenGouthro

Born at Glace Bay in the County of Cape Breton

That RoseleenGouthro Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on October 22, 1923

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

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