Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Roderick McDougall death at Glace Bay, Cape Breton County on January 17, 1971
Male Death Registration: Year: 1971 number: 1566
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001566
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution 222 Eighth St.
3. PRINT NAME OF DECEASED McDougall, Roderick
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
single
8. BIRTHPLACE Newfoundland
9. DATE OF BIRTH , 1893
10. AGE in Years77 Months Days | hrs or mins
11. Trade or profession Miner
12. Kind of industry Dom. Coal Co.
13. Date last worked 1964 14. Total years 55
15. If married name of spouse
16. NAME of Father Neil McDougall
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Bridget Pittman
19. BIRTHPLACE Newfoundland
20. Signature of Informant Neil McDougall
address Centre Ave., Glace Bay
Relationship to deceased Nephew
21. Place of burial St. John Cem., Glace Bay
Date of burial January 20, 1971
22. Undertaker Curry's Funeral Home, Glace Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 17, 1971
CAUSE OF DEATH
(a) Myocardial infarction
(b)
(c)
other
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