Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Robert Terry Smith death at Cole Harbour, Halifax County on April 23, 1971
Male Death Registration: Year: 1971 number: 3048
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003048
1. PLACE OF DEATH County of Halifax If in City or Town Cole Harbour
If death occured in a hospital or institution Halifax County Hospital
3. PRINT NAME OF DECEASED Smith, Robert Terry
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Springhill
9. DATE OF BIRTH 10 30, 1951
10. AGE in Years19 Months5 Days24 | hrs or mins
11. Trade or profession n.a
12. Kind of industry n.a
13. Date last worked n.a 14. Total years n.a
15. If married name of spouse n.a
16. NAME of Father Charles Frederick Smith
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Thelma Wiseman
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Thelma Smith (Charles)
address 181 Herritt Rd, Springhill, NS
Relationship to deceased mother
21. Place of burial Rodney, Cumb. Co, NS
Date of burial April 26 1971
22. Undertaker A.H. Brown, Funeral Services Ltd. Springhill NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 23, 1971
CAUSE OF DEATH
(a) Lymphedema palsy
(b) Cancer (undetermined)
(c)
other Mongolism
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