Male Death Registration: Year: 1971 number: 1394
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001394
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Hospital
3. PRINT NAME OF DECEASED Colquhoun, Gordon Allan
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Clark's Harbour, Shelb. County
9. DATE OF BIRTH 12 6, 1894
10. AGE in Years76 Months1 Days7 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Fisherman
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother Matilda Nickerson
19. BIRTHPLACE Shelb. Co.
20. Signature of Informant Austin G. Colquhoun
address Sand Beach, Yar. Co.
Relationship to deceased Son
21. Place of burial Cheboque, Yar. Co.
Date of burial January 16, 1971
22. Undertaker Sweeny's Funeral Home, Yar.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 13, 1971
CAUSE OF DEATH
(a) Septicemia
(b) Pericarditis
(c) Exposure
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=493472
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