Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John William Smith death at Sydney, Cape Breton County on August 2, 1970
Male Death Registration: Year: 1970 number: 4909
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004909
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution St. Rita Hospital
3. PRINT NAME OF DECEASED Smith, John William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
single
8. BIRTHPLACE Grand River
9. DATE OF BIRTH 12 12, 1907
10. AGE in Years62 Months7 Days21 | hrs or mins
11. Trade or profession Miller
12. Kind of industry
13. Date last worked 14. Total years 42
15. If married name of spouse
16. NAME of Father Alexander John Smith
17. BIRTHPLACE Grand River
18. NAME of Mother Cassie Belle Campbell
19. BIRTHPLACE West Bay
20. Signature of Informant Miss. M. K. Smith
address Grand River
Relationship to deceased Sister
21. Place of burial Grand River Cemetery
Date of burial August 5, 1970
22. Undertaker Alex A. Morrison, Grand River
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 2, 1970
CAUSE OF DEATH
(a) carcinoma tongue
(b) Pulmonary _________
(c) cardiac failure
other
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