Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Roland Perry MacBurnie death at Five Islands, Colchester County on September 13, 1971
Male Death Registration: Year: 1971 number: 5490
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005490
1. PLACE OF DEATH County of Colchester If in City or Town Five Islands
3. PRINT NAME OF DECEASED MacBurnie, Roland Perry
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Five Islands, Colchester Co, N.S
9. DATE OF BIRTH 5 13, 1925
10. AGE in Years46 Months4 Days | hrs or mins
11. Trade or profession Labourer
12. Kind of industry
13. Date last worked 14. Total years 35
15. If married name of spouse Marie (Boggs) MacBurnie
16. NAME of Father Alfred MacBurnie
17. BIRTHPLACE N.S
18. NAME of Mother Myrtle Lockhart
19. BIRTHPLACE N.S
20. Signature of Informant Arnold A. MacBurnie
address Five Islands, N.S
Relationship to deceased Brother
21. Place of burial Five Islands, N.S
Date of burial Sept 17, 1971
22. Undertaker S.W Smith + Son Ltd. Parrsbaro, N.S
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 13, 1971
CAUSE OF DEATH
(a) Carbon monoxide poisoning
(b)
(c)
other Suicide
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