Male Death Registration: Year: 1971 number: 5104
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005104
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution Glace Bay General Hospital
3. PRINT NAME OF DECEASED Burt, William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Newfoundland
9. DATE OF BIRTH 8 9, 1896
10. AGE in Years74 Months10 Days27 | hrs or mins
11. Trade or profession Retired Fisherman
12. Kind of industry Self Employed
13. Date last worked 1967 14. Total years 50 yrs
15. If married name of spouse Keziar Burt
16. NAME of Father Andrew Burt
17. BIRTHPLACE Newfoundland
18. NAME of Mother
19. BIRTHPLACE Newfoundland
20. Signature of Informant Keziar Burt
address 16 Wadman St, Glace Bay
Relationship to deceased Wife
21. Place of burial Forest Haven, Cape Breton Co., NS
Date of burial July 8, 1971
22. Undertaker Patten's Funeral Home Ltd., Glace Bay, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 6, 1971
CAUSE OF DEATH
(a) Coronary Thrombosis
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=497178
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