Male Death Registration: Year: 1971 number: 3149
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003149
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution D.E.V.C.O. No. 26 Colliery
3. PRINT NAME OF DECEASED Matheson, James Edward
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Glace Bay
9. DATE OF BIRTH 9 28, 1938
10. AGE in Years32 Months4 Days26 | hrs or mins
11. Trade or profession Coal Miner, D.E.V.C.O.
12. Kind of industry Coal mining
13. Date last worked Feb 23/71 14. Total years
15. If married name of spouse Patsy McKenzie
16. NAME of Father Melvin Matheson
17. BIRTHPLACE Glace Bay, NS
18. NAME of Mother Lillian Howie
19. BIRTHPLACE Glace Bay, NS
20. Signature of Informant Melvin Matheson
address 647 David St. Glace Bay, NS
Relationship to deceased Father
21. Place of burial St, Anne's, Glace Bay, NS
Date of burial Feb 26, 1971
22. Undertaker V.J. McGillivray Funeral Homes Limited, Glace Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 23, 1971
CAUSE OF DEATH
(a) Fracture neck & skull & complete fracture of the bones
(b)
(c)
other Industrial Accident
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=495225
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