Male Death Registration: Year: 1971 number: 4762
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004762
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney Mines
If death occured in a hospital or institution Harbour View Hospital
3. PRINT NAME OF DECEASED Smith, James
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scotish
7. Single, Married
married
8. BIRTHPLACE Scotland
9. DATE OF BIRTH 7 25, 1899
10. AGE in Years72 Months0 Days8 | hrs or mins
11. Trade or profession Miner
12. Kind of industry Coal Mining
13. Date last worked 1953 14. Total years 45
15. If married name of spouse Martha Campbell
16. NAME of Father James Smith
17. BIRTHPLACE Scotland
18. NAME of Mother Janet Bennett Stephenson
19. BIRTHPLACE Scotland
20. Signature of Informant William E. Smith
address 58 Guy St., Sydney Mines, NS
Relationship to deceased Son
21. Place of burial St Andrews Cemetery, Sydney Mines
Date of burial August 6, 1971
22. Undertaker Fillmore & Whitman Funeral Home Ltd. Sydney Mines
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 3, 1971
CAUSE OF DEATH
(a) Cerebrovascular Accident
(b) Arteriosclerotic Heart Disease
(c)
other Pulmonary Emphysema & Carcinoma of Lung?
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=496837
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