Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Frederick William Smith death at Kentville, Kings County on August 15, 1970
Male Death Registration: Year: 1970 number: 5289
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005289
1. PLACE OF DEATH County of Kings If in City or Town Kentville
If death occured in a hospital or institution Nova Scotia Sanatorium, Kentville
3. PRINT NAME OF DECEASED Smith, Frederick William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
separated
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 9 14, 1892
10. AGE in Years77 Months11 Days1 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Mrs. Frederick W. Smith
16. NAME of Father Frederick Smith
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Mary Mansfield
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Records Dept. Sanatorium
address Kentville
Relationship to deceased None
21. Place of burial Westfield, Queens Co.
Date of burial 18 August 1970
22. Undertaker Chandlers Funeral Services Ltd., Liverpool, Queens Co.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 15, 1970
CAUSE OF DEATH
(a) Pneumonia Lobar
(b) Pulmonary Tuberculosis (inactive)
(c)
other Pulmonary Fibrosis & Emphysema
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