Male Death Registration: Year: 1971 number: 4951
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004951
1. PLACE OF DEATH County of Kings If in City or Town Berwick
If death occured in a hospital or institution Grand View Manor
3. PRINT NAME OF DECEASED Peterson, Owen William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Chipman Brook, Kings County Nova Scotia
9. DATE OF BIRTH 10 17, 1888
10. AGE in Years82 Months9 Days6 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Edna Arenburgh
16. NAME of Father Peter Peterson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Ida Sanford
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs Edna Peterson
address Cambridge, Kings Co. NS
Relationship to deceased wife
21. Place of burial Berwick, NS
Date of burial July 26, 1971
22. Undertaker H C Lindsay Funeral Home , Berwick
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 23, 1971
CAUSE OF DEATH
(a) Bronchopneumonia
(b) Arteriosclerotic Heart Disease
(c)
other Senility
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=497026
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