BCH 169304 CERTIFIED COPY OF AN ENTRY Pursuant to the Births and Deaths Registration Act 1953 Kime KSEXS 15 0 BIRTH >| xo” 150. rogutsin suse Flock nary a la ca. aie gygn beees Tene ve Qe 1aaG cae co ot f . FATHER Y 7 uM Mom { TAR BAR 5 Place of tinh i PIS AEs Occupation Heconntoent a Coting Irligro ik aaAe & Place of bith =) z LS alas Fee (6) Maiden eur 18) Surame a mariage is iWaifferent from >I DOIQue maiden surname = “wareetion BC Hundsey Rood. RS eth —. ea place of child's bi INFORMANT 11. Name and surname fF ot the mother or fate) | 12.Quatneaion — LY Hs 18, Usual address (if different from that in 10 above) 14; I certify that the particulars entered above are true to the best of my knowledge and belief ene AAP OB so AUQOAC cccscccsissete Eee Mgnt Cg [ORNS Des SY ~t oa Tro 17, Name given aftar registration, ‘and eurname ConiedDspe ee py of neni arepisterin my cst fe t- 2 —~ { py eee va \\ as ‘Siri ou whichever does ot ams yy (CAUTION: THERE ARE OFFENCES RELATING TO FALSIFYING OR ALTERING A CERTIFICATE AND USING ‘OR POSSESSING A FALSE CERTIFICATE. °CROWN COPYRIGHT WARNING: A CERTIFICATE IS NOT EVIDENCE OF IDENTITY.