Male Death Registration: Year: 1971 number: 4105
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004105
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Izaak Walton Killam Hospital
3. PRINT NAME OF DECEASED More, Robert Edward
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 6 26, 1971
10. AGE in Years Months Days4 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked Infant 14. Total years
15. If married name of spouse
16. NAME of Father Alan More
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Judith Estabrooks
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mr. Alan More
address 122 Dorothea Drive, Dart.
Relationship to deceased Father
21. Place of burial Woodlawn Cem. Dart.
Date of burial July 1 '71
22. Undertaker A.L. Mattatall Fun. Serv. Ltd., Dartmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 30, 1971
CAUSE OF DEATH
(a) Congenital heart disease
(b) Tricuspid valve atresia Tricuspid Valve atresia
(c)
other Cardiac failure
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=496180
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