Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Samuel George Johnson death at Antigonish, Antigonish County on February 22, 1971
Male Death Registration: Year: 1971 number: 1858
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001858
1. PLACE OF DEATH County of Antigonish If in City or Town Antigonish
If death occured in a hospital or institution St Martha's Hospital, Antigonish, NS
3. PRINT NAME OF DECEASED Johnson, Samuel George
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Country Harbour Mines, Guys Co
9. DATE OF BIRTH 3 31, 1889
10. AGE in Years81 Months10 Days22 | hrs or mins
11. Trade or profession Retired Miner
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Hilda Silver
16. NAME of Father Thomas Johnson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Priscilla Cooke
19. BIRTHPLACE Nova Scotia
20. Signature of Informant John N Henderson
address RR #1 Cross Roads Country Hbr
Relationship to deceased
21. Place of burial Country Hbr Mines
Date of burial Feb 24,1971
22. Undertaker GP Giffin, Goldboro, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 22, 1971
CAUSE OF DEATH
(a) Carcinoma of stomach with widespread metastasis-liver[illegible]
(b)
(c) severe chronic [illegible]
other
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