Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Henrie Jean Roach death at Cheticamp, Inverness County on June 4, 1971
Male Death Registration: Year: 1971 number: 4551
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004551
1. PLACE OF DEATH County of Inverness If in City or Town Cheticamp
If death occured in a hospital or institution Sacred heart Hospital
3. PRINT NAME OF DECEASED Roach, Henrie Jean
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE
9. DATE OF BIRTH 8 24, 1873
10. AGE in Years97 Months9 Days11 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Marie Roach
16. NAME of Father Jean Roach
17. BIRTHPLACE Inverness County, NS
18. NAME of Mother Helen Poirier
19. BIRTHPLACE Inverness County, NS
20. Signature of Informant Harris H Chaisson
address Cheticamp, NS
Relationship to deceased
21. Place of burial Cheticamp, NS
Date of burial June 6, 1871
22. Undertaker H H Chaisson, Cheticamp
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 4, 1971
CAUSE OF DEATH
(a) Cancer of stomach
(b)
(c)
other very old age
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