Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Simone Misia death at Dartmouth, Halifax County on August 24, 1971
Male Death Registration: Year: 1971 number: 5271
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005271
1. PLACE OF DEATH County of Halifax If in City or Town Dartmouth
3. PRINT NAME OF DECEASED Misia, Simone
4. Sex
Male
5. Citizenship
Italian
6. Racial Origin
Italian
7. Single, Married
married
8. BIRTHPLACE Italy
9. DATE OF BIRTH 10 , 1930
10. AGE in Years40 Months10 Days | hrs or mins
11. Trade or profession Seaman
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant F.K Warren Ltd
address 5162 Duke St, Hfx.
Relationship to deceased Shipping Agent
21. Place of burial Palermo, Barcelona, Italy
Date of burial August 31, 1971
22. Undertaker Snow & Co Ltd
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 24, 1971
CAUSE OF DEATH
(a) Fracture - Dislocation of neck
(b) car - pedestrian accident
(c)
other
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