Male Death Registration: Year: 1971 number: 5382
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005382
1. PLACE OF DEATH County of Inverness If in City or Town Cheticamp
If death occured in a hospital or institution Sacred Heart Hospital
3. PRINT NAME OF DECEASED Roach, Daniel
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Inverness
9. DATE OF BIRTH 12 15, 1896
10. AGE in Years74 Months7 Days13 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Elizabeth Roach
16. NAME of Father Constant Roach
17. BIRTHPLACE Inverness County
18. NAME of Mother Julienne Blanchard
19. BIRTHPLACE Inverness County
20. Signature of Informant Mrs. Stella Power
address Cheticamp, Inv. Co.
Relationship to deceased Daughter
21. Place of burial Cheticamp
Date of burial July 31, 1971
22. Undertaker Louis L. Chaisson & Son. Cheticamp
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 28, 1971
CAUSE OF DEATH
(a) Carcinoma of stomach
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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