Male Death Registration: Year: 1971 number: 5624
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005624
1. PLACE OF DEATH County of Guysborough If in City or Town Sherbrooke
If death occured in a hospital or institution St. Mary's Hospital
3. PRINT NAME OF DECEASED Smith, Isaac Ashmore
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Irish
7. Single, Married
widowed
8. BIRTHPLACE Smithfield, Guysborough County
9. DATE OF BIRTH 10 24, 1887
10. AGE in Years83 Months10 Days9 | hrs or mins
11. Trade or profession Retired Farmer
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father John Smith
17. BIRTHPLACE Smithfield, Guysborough Co., NS
18. NAME of Mother Jennie Taylor
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Edwin Smith
address Smithfield, Guysborough Co., NS
Relationship to deceased Son
21. Place of burial Smithfield, Guysborough Co., NS
Date of burial 4 September 1971
22. Undertaker Vienotte & Sons Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 2, 1971
CAUSE OF DEATH
(a) Cardiovascular Renal Disease
(b)
(c)
other Hypostatic Pneumonia
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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