Male Death Registration: Year: 1971 number: 4392
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004392
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution St. Rita Hospital
3. PRINT NAME OF DECEASED MacKenzie, Lauchlin Francis
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Sydney
9. DATE OF BIRTH 4 26, 1918
10. AGE in Years53 Months2 Days7 | hrs or mins
11. Trade or profession City of Sydney
12. Kind of industry Labourer
13. Date last worked 1963 14. Total years
15. If married name of spouse Alma Romard
16. NAME of Father Lauchie MacKenzie
17. BIRTHPLACE P.E.I.
18. NAME of Mother Eliza Carver
19. BIRTHPLACE P.E.I.
20. Signature of Informant Alma Romard
address 152 Tupper St., Sydney
Relationship to deceased Common-law-wife
21. Place of burial Forest Haven Memorial Gardens, Sydney-Glace Bay Highway, CB, NS
Date of burial July 5, 1971
22. Undertaker R.H. Fillmore Funeral Home Ltd., Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 3, 1971
CAUSE OF DEATH
(a) Rheumatic heart disease
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=496467
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