Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charlotte Hazel Dolliver death at Bridgewater, Lunenburg County on August 23, 1970
Female Death Registration: Year: 1970 number: 5143
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005143
1. PLACE OF DEATH County of Lunenburg If in City or Town Bridgewater
If death occured in a hospital or institution Dawson Memorial Hospital
3. PRINT NAME OF DECEASED Dolliver, Charlotte Hazel
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Caribou
9. DATE OF BIRTH 12 14, 1889
10. AGE in Years80 Months8 Days9 | 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 Melville MacDonald
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Elizabeth Young
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Douglas Mosher
address Lunenburg
Relationship to deceased Daughter
21. Place of burial Bridgewater
Date of burial August 26, 1970
22. Undertaker Charles Sweeny, Bridgewater
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 23, 1970
CAUSE OF DEATH
(a) Myocardial Infarction
(b)
(c)
other
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