Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Shirley Clair Farnsworth death at Middleton, Annapolis County on August 30, 1970
Male Death Registration: Year: 1970 number: 5588
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005588
1. PLACE OF DEATH County of Annapolis If in City or Town Middleton
If death occured in a hospital or institution Soldiers Memorial Hospital
3. PRINT NAME OF DECEASED Farnsworth, Shirley Clair
4. Sex
Male
5. Citizenship
American
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Hampton
9. DATE OF BIRTH 12 5, 1899
10. AGE in Years70 Months8 Days25 | hrs or mins
11. Trade or profession
12. Kind of industry Retired machinist
13. Date last worked 14. Total years
15. If married name of spouse Mrs. Evelyn Bradley Farnsworth
16. NAME of Father Reid Farnsworth
17. BIRTHPLACE Hampton
18. NAME of Mother Annie Munroe
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Evelyn Farnsworth
address Hampton
Relationship to deceased Wife
21. Place of burial Hampton
Date of burial September 2, 1970
22. Undertaker Bridgetown Funeral Home, Robert L. Hall
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 30, 1970
CAUSE OF DEATH
(a) Retroperitoneal Sarcoma - with metastasis
(b)
(c)
other
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