Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Samuel Russell Forbes death at Halifax, Halifax County on February 9, 1971
Male Death Registration: Year: 1971 number: 1690
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001690
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary
3. PRINT NAME OF DECEASED Forbes, Samuel Russell
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Canada
9. DATE OF BIRTH 5 23, 1902
10. AGE in Years68 Months8 Days17 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Druggixt
13. Date last worked 14. Total years
15. If married name of spouse Ruth E. Forbes
16. NAME of Father Allister Forbes
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Anna Lohnes
19. BIRTHPLACE Nova Scotia
20. Signature of Informant John J. Forbes
address Liverpool
Relationship to deceased Son
21. Place of burial Liverpool
Date of burial February 12, 1971
22. Undertaker Chanellers' Funeral Service Ltd., Liverpool
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 9, 1971
CAUSE OF DEATH
(a) Respiratory muscle paralysis
(b) Lung Cancer with Metastasis
(c)
other
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