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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000172

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

Date of Birth January 8, 1924 Place of Birth Glace BayCounty of Cape Breton

Name of Father Ernest Albert Kinslow MAIDEN NAME of Mother Henrietta Simmons

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 104 Ocean Avenue, Glace Bay, Cape Breton Co., NS

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 Mrs. Dolena Hampton Address of Applicant 37 North Street, Glace Bay, Cape Breton Co., NS Date 13 June 1956

Relationship of Applicant to child Self

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That DolenaKinslow Whose Birth is sought to be registered was

born at Glace Bay Cape Breton County on January 8, 1924

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

I am her mother - school record attached - hospital records (marriage record)

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