Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Olaf Olsen death at Oakland, Lunenburg County on June 17, 1971
Male Death Registration: Year: 1971 number: 4176
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004176
1. PLACE OF DEATH County of Lunenburg If in City or Town Oakland
3. PRINT NAME OF DECEASED Olsen, Olaf
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Norwegian
7. Single, Married
married
8. BIRTHPLACE Sarpsborg, Norway
9. DATE OF BIRTH 11 3, 1908
10. AGE in Years62 Months7 Days14 | hrs or mins
11. Trade or profession Painter
12. Kind of industry
13. Date last worked January /71 14. Total years
15. If married name of spouse Mrs. Connie Olsen
16. NAME of Father Henrik Olsen
17. BIRTHPLACE Sarpsborg, Norway
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Mary C. Olsen
address RR #2, Mahone Bay
Relationship to deceased Wife
21. Place of burial Park Cemetery, Mahone Bay
Date of burial June 20, 1971
22. Undertaker Mahone Funeral Service & Ambulance, Mahone Bay, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 17, 1971
CAUSE OF DEATH
(a) Bronchopneumonia
(b) Carcinoma of Lung
(c)
other
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