Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Roland Edward Forward death at North Sydney, Cape Breton County on April 1, 1971
Male Death Registration: Year: 1971 number: 2619
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002619
1. PLACE OF DEATH County of Cape Breton If in City or Town North Sydney
If death occured in a hospital or institution Peppett St.
3. PRINT NAME OF DECEASED Forward, Roland Edward
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE North Sydney
9. DATE OF BIRTH 1 4, 1966
10. AGE in Years5 Months2 Days27 | hrs or mins
11. Trade or profession Child
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Earl William Forward
17. BIRTHPLACE Newfoundland
18. NAME of Mother Gladys Thomas
19. BIRTHPLACE Newfoundland
20. Signature of Informant Mrs. Gladys Forward
address 131 Peppett St., North Sydney
Relationship to deceased Mother
21. Place of burial Lakeside Cemetery, North Sydney
Date of burial April 3, 1971
22. Undertaker Fillmore & Whitman Funeral Home Ltd., North Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 1, 1971
CAUSE OF DEATH
(a) Multiple injuries head, neck, thorax, fracture left leg
(b)
(c) struck by motor car
other Accident
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