Male Death Registration: Year: 1971 number: 3095
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003095
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Hospital
3. PRINT NAME OF DECEASED Daw, Kenneth Albert
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE London, Ont.
9. DATE OF BIRTH 12 26, 1942
10. AGE in Years28 Months3 Days15 | hrs or mins
11. Trade or profession at home
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Kitchener Daw
17. BIRTHPLACE Dundas, Ont.
18. NAME of Mother Margaret Neilson
19. BIRTHPLACE Victoria Co, NB
20. Signature of Informant Kitchener Daw
address South Ohio, Yar. Co., NS
Relationship to deceased Father
21. Place of burial Pleasant Valley, Yar. Co.
Date of burial April 13, 1971
22. Undertaker Sweeny's Funeral Home, Yarmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 10, 1971
CAUSE OF DEATH
(a) Pneumonia
(b) Brain tumor
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=495171
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