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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000242

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

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

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

Name of Father Daniel Petrie MAIDEN NAME of Mother Mary McKenzie

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 Deceased

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 Mrs. Mary Petrie Address of Applicant 693 Arthur Street, Glace Bay, Cape Breton Co., NS Date 6 January 1962

Relationship of Applicant to child Mother

AFFIDAVIT

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

Born at Glace Bay in the County of Cape Breton

That CamillaPetrie 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:

Mother of Camilla Petrie

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