Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Lewrena Camillus Harrietha death at Sydney Mines, Cape Breton County on August 8, 1971
Female Death Registration: Year: 1971 number: 4766
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004766
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 Harrietha, Lewrena Camillus
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 12 19, 1919
10. AGE in Years51 Months7 Days20 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry at home
13. Date last worked 14. Total years
15. If married name of spouse Wilfred Harrietha
16. NAME of Father Gardiner Potter
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Susan Jessome
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Wilfred Harrietha
address 21 Black Point, Sydney Mines
Relationship to deceased Husband
21. Place of burial St. Josephs, Sydney Mines
Date of burial Aug 10, 1971
22. Undertaker George R. Francis, Sydney Mines, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 8, 1971
CAUSE OF DEATH
(a) Pulmonary Embolism
(b) Small Bowel Resection
(c)
other Acute Localized Regional ileitis
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