Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Rose Ann Smith death at Broad Cove, Lunenburg County on September 3, 1970
Female Death Registration: Year: 1970 number: 5294
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005294
1. PLACE OF DEATH County of Lunenburg If in City or Town Broad Cove
If death occured in a hospital or institution Broad Cove , Lunenburg
3. PRINT NAME OF DECEASED Smith, Rose Ann
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
single
8. BIRTHPLACE Broad Cove
9. DATE OF BIRTH 9 3, 1970
10. AGE in Years Months Days | hrs or 20 mins
11. Trade or profession Baby
12. Kind of industry Nil
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father James Smith
17. BIRTHPLACE Broad Cove
18. NAME of Mother Rose Mary Smith
19. BIRTHPLACE Bridgewater
20. Signature of Informant Carl Smith
address Broad Cove , Lunenburg , Co
Relationship to deceased Grandmother
21. Place of burial Broad Cove , Lunenburg , Co
Date of burial September 3 , 1970
22. Undertaker Stand Wamback , Bridgwater
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 3, 1970
CAUSE OF DEATH
(a) Asphyxia Neohatovum
(b)
(c)
other
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