Female Death Registration: Year: 1971 number: 4594
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004594
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Civic Hospital
3. PRINT NAME OF DECEASED Gjerde, Annabelle Derusia
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
married
8. BIRTHPLACE Ryley, Alta.
9. DATE OF BIRTH 6 6, 1914
10. AGE in Years57 Months Days8 | 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 Robert Andrew Gjerde
16. NAME of Father Gary Sykes
17. BIRTHPLACE U S A
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Mr Robert Gjerde
address 24 A Settle St. Dartmouth
Relationship to deceased husband
21. Place of burial Hillcrest Memorial Gardens, Lr. Sackville, Hfx. Co. NS
Date of burial June 16, 1971
22. Undertaker A L Mattatall Funeral Service Ltd. Dartmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 14, 1971
CAUSE OF DEATH
(a) Multiple fractures
(b) Carcinoma of Breast with Osseous metastases
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=496669
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