Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Kenneth Robert Cook death at Weymouth, Digby County on June 4, 1970
Male Death Registration: Year: 1970 number: 4304
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004304
1. PLACE OF DEATH County of Digby If in City or Town Weymouth
If death occured in a hospital or institution at home
3. PRINT NAME OF DECEASED Cook, Kenneth Robert
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Weymouth
9. DATE OF BIRTH 11 11, 1964
10. AGE in Years5 Months6 Days24 | hrs or mins
11. Trade or profession At home
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Gordon Cook
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Laura Stark
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Gordon Cook
address Weymouth
Relationship to deceased Father
21. Place of burial Weymouth
Date of burial June 6, 1970
22. Undertaker Weymouth Funeral Home Ltd., Box 24, Weymouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 4, 1970
CAUSE OF DEATH
(a) Drowning
(b)
(c)
other Accident - fell into well
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