Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Rose Simcsik death at Sydney, Cape Breton County on April 11, 1970
Female Death Registration: Year: 1970 number: 2869
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002869
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution City Hospital, Sydney
3. PRINT NAME OF DECEASED Simcsik, Rose
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Polish
7. Single, Married
widowed
8. BIRTHPLACE Poland
9. DATE OF BIRTH 9 13, 1927
10. AGE in Years42 Months6 Days29 | hrs or mins
11. Trade or profession Restaurant Operator
12. Kind of industry Food
13. Date last worked 5 April 1970 14. Total years 8 years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Elizabeth Campbell
address Louisbourg
Relationship to deceased Daughter
21. Place of burial Stella Maris Cemetery, Louisbourg Co.
Date of burial 14 April 1970
22. Undertaker D.M. Johnston, Louisbourg
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 11, 1970
CAUSE OF DEATH
(a) Uremia
(b) Polycystic Kidney
(c)
other
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