Male Death Registration: Year: 1971 number: 2083
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002083
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 Mont, Thomas Richard
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Avondale
9. DATE OF BIRTH 8 11, 1893
10. AGE in Years77 Months6 Days11 | hrs or mins
11. Trade or profession Miner
12. Kind of industry Coal Mining
13. Date last worked 1946 14. Total years 37 yrs
15. If married name of spouse Annie Laura Mont
16. NAME of Father John Mont
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Martha Warner
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Rita M Walsh
address Apmt 101, 6701 Chisholm Ave. Halifax, NS
Relationship to deceased
21. Place of burial Springhill, NS
Date of burial February 25, 1971
22. Undertaker A H Brown Funeral Service Ltd, Springhill, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 22, 1971
CAUSE OF DEATH
(a) Acute myocardial Infarction
(b) Pulmonary Edema
(c) Chronic Obstructive Lung Disease
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=494160
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