Nova Scotia Archives

Nova Scotia Births, Marriages, and Deaths

Samuel Johnson death at Sydney, Cape Breton County on March 26, 1971

Male Death Registration: Year: 1971 number: 2615

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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH

02 - 002615

1. PLACE OF DEATH   County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution Sydney City Hospital

3. PRINT NAME OF DECEASED Johnson, Samuel

4. Sex

Male

5. Citizenship

Canadian

6. Racial Origin

English

7. Single, Married

married

8. BIRTHPLACE Sydney

9. DATE OF BIRTH 2  11, 1907

10. AGE in  Years64  Months1  Days15 | hrs or mins

11. Trade or profession Industrial Relations

12. Kind of industry DEVCO

13. Date last worked 1971       14. Total years 15 yrs

15. If married name of spouse Margaret Jane White

16. NAME of Father Angus Johnson

17. BIRTHPLACE Leitches Creek, Cape Breton

18. NAME of Mother Mary  Johnson

19. BIRTHPLACE Leitches Creek, Cape Breton

20. Signature of Informant Mrs Samuel Johnson

      address New Victoria, Cape Breton, NS

      Relationship to deceased wife

21. Place of burial St Alphonse Cemetery, Victoria Mines, NS

      Date of burial March 28, 1971

22. Undertaker V J McGillivray Funeral Homes Limited, New Waterford, NS

MEDICAL CERTIFICATE OF DEATH

23. DATE OF DEATH March 26, 1971

CAUSE OF DEATH

(a) Bronchopneumonia

(b) Chronic Bronchitis

(c) Emphysema

other Pulmonary Tuberulosis Inactive

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