Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Harvey Elmer Simmons death at Glace Bay, Cape County on April 1, 1971
Male Death Registration: Year: 1971 number: 2729
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002729
1. PLACE OF DEATH County of Cape If in City or Town Glace Bay
If death occured in a hospital or institution Glace Bay General Hospital
3. PRINT NAME OF DECEASED Simmons, Harvey Elmer
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Donkin, CB
9. DATE OF BIRTH 11 10, 1916
10. AGE in Years54 Months4 Days22 | hrs or mins
11. Trade or profession War Veterans Allowance
12. Kind of industry DVA pensioner
13. Date last worked 14. Total years
15. If married name of spouse Mrs eila Simmons
16. NAME of Father William Simmons
17. BIRTHPLACE Newfoundland
18. NAME of Mother Sadie Patton
19. BIRTHPLACE Newfoundland
20. Signature of Informant Mrs Neila Simmons
address 20 Dolphin Crescent, Glace Bay
Relationship to deceased wife
21. Place of burial Glace Bay, CB
Date of burial April 4, 1971
22. Undertaker Pattens Funeral Home Ltd, Glace Bay, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 1, 1971
CAUSE OF DEATH
(a) Leukemia
(b) Pneumonia
(c)
other
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