Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
George Herman death at New Glasgow, Pictou County on July 19, 1971
Male Death Registration: Year: 1971 number: 5159
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005159
1. PLACE OF DEATH County of Pictou If in City or Town New Glasgow
3. PRINT NAME OF DECEASED Herman, George
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Polish
7. Single, Married
married
8. BIRTHPLACE Poland
9. DATE OF BIRTH 3 20, 1884
10. AGE in Years87 Months3 Days29 | hrs or mins
11. Trade or profession Retired Pipe Maker
12. Kind of industry Standard Clay Industry
13. Date last worked 14. Total years 40 yrs
15. If married name of spouse Anne Smith
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Mrs. Thomas Fraser
address 936 East River Rd, New Glasgow, NS
Relationship to deceased Granddaughter
21. Place of burial Holy Name Cemetery, Westville
Date of burial July 22, 1971
22. Undertaker Eagles Funeral Home, Westville, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 19, 1971
CAUSE OF DEATH
(a) Pneumonia
(b) Chronic Pulmonary Disease
(c)
other
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