Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Cleophas Gallivan death at Sydney, Cape County on March 30, 1971
Male Death Registration: Year: 1971 number: 2721
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002721
1. PLACE OF DEATH County of Cape If in City or Town Sydney
If death occured in a hospital or institution St Rita Hospital
3. PRINT NAME OF DECEASED Gallivan, Cleophas
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Cape Breton
9. DATE OF BIRTH 8 6, 1889
10. AGE in Years81 Months7 Days24 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father William MacGillivray
17. BIRTHPLACE Cape Breton
18. NAME of Mother Cecelia MacPhee
19. BIRTHPLACE Cape Breton
20. Signature of Informant Mr William Gallivan
address 160 Shore Road, Sydney, NS
Relationship to deceased Son
21. Place of burial Calvary Cemetery, Sydney, NS
Date of burial April 1, 1971
22. Undertaker T W Curry Limited, Sydney, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 30, 1971
CAUSE OF DEATH
(a) Myocardial failure
(b)
(c)
other
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