Male Death Registration: Year: 1971 number: 5611
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005611
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution General Hospital
3. PRINT NAME OF DECEASED Harn, Robert William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE London, England
9. DATE OF BIRTH 9 10, 1883
10. AGE in Years88 Months Days11 | hrs or 2 mins
11. Trade or profession Meat Cutter
12. Kind of industry Meat Market
13. Date last worked 14. Total years
15. If married name of spouse Catherine Rider (deceased)
16. NAME of Father Robert Harn
17. BIRTHPLACE England
18. NAME of Mother Irene Jackman
19. BIRTHPLACE England
20. Signature of Informant Mrs. Margaret MacQueen
address 80 McIntyre Lane, Glace Bay, Cape Breton Co., NS
Relationship to deceased Niece
21. Place of burial Forest Road Anglican Cemetery, St. John's, Newfoundland
Date of burial 22 September 1971
22. Undertaker V. J. McGillivray Funeral Homes Ltd., Glace Bay, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 21, 1971
CAUSE OF DEATH
(a) Arteriosclerotic Heart Disease
(b) Arteriosclerosis
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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