Female Death Registration: Year: 1970 number: 6022
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006022
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution St. Joseph's Hospital
3. PRINT NAME OF DECEASED Merlin, Agnes Agatha
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Irish
7. Single, Married
widowed
8. BIRTHPLACE Campbellton, New Brunswick
9. DATE OF BIRTH 11 22, 1889
10. AGE in Years80 Months10 Days19 | hrs or mins
11. Trade or profession Household Duties
12. Kind of industry at home
13. Date last worked September 1969 14. Total years
15. If married name of spouse Edward Merlin
16. NAME of Father Charles Layes
17. BIRTHPLACE Campbellton, New Brunswick
18. NAME of Mother Mary Jane O'Callahan
19. BIRTHPLACE New Brunswick
20. Signature of Informant Mrs. Bernard Burton
address 26 Alexander St. Glace Bay
Relationship to deceased Daughter
21. Place of burial St. Anne's, Glace Bay
Date of burial October 13, 1970
22. Undertaker V.J. McGillivray Funeral Homes Ltd. Glace Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 11, 1970
CAUSE OF DEATH
(a) General Alteroscliosis
(b) CVA
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=491329
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