Section 4. The mother of a child who was born without a physician or hospital medical officer in attendance shall, within thirty days after the birth of such child, file a report of such birth, signed and sworn to by her, setting forth the facts required for a record as provided in section one, with the clerk or registrar of the city or town wherein such birth occurred. Such report shall be on a form prepared and furnished to the clerk by the commissioner. Written evidence substantiating such facts shall be required by said clerk or registrar and if he is satisfied as to the truth and accuracy thereof, he shall make a record of such birth. If, however, in the opinion of the clerk or registrar such evidence is not satisfactory, he shall refuse, in writing, to record such birth. The mother may then present a petition, together with such written refusal and her evidence to establish the validity of such record, to a judge of the probate court for the county where such birth occurred. Written notice shall be given to said clerk or registrar of the time and place of the hearing on such petition. After such hearing, if the court is of the opinion that such birth should be recorded, it shall order such recording. Upon receipt of such order, the clerk or registrar shall make a record of such birth.