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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000146

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mildred KathleenChislett Sex Female

Date of Birth May 28, 1924 Place of Birth Glace BayCounty of Cape Breton

Name of Father George Chislett MAIDEN NAME of Mother Jane Decker

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

Residence of Father when child was born Catalone, Cape Breton Co., NS Present address of Father Toronto, Ontario

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

Race Name and present address of Physician in attendance at birth

Signature of Applicant Jane Chislett Address of Applicant 533 McLeod Street, Ottawa, Ontario Date 14 May 1954

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mildred KathleenChislett

Born at Glace Bay in the County of Cape Breton

That Mildred KathleenChislett Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on May 28, 1924

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

I am her mother (Church baptism records)

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