Male Death Registration: Year: 1971 number: 5635
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005635
1. PLACE OF DEATH County of Hants If in City or Town Windsor
If death occured in a hospital or institution Payzant Memorial Hospital, Windsor, NS
3. PRINT NAME OF DECEASED Burgess, Silas William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 11, 1895
10. AGE in Years85 Months11 Days3 | hrs or mins
11. Trade or profession Carpenter
12. Kind of industry Woodwork
13. Date last worked 1951 14. Total years 45 years
15. If married name of spouse
16. NAME of Father George Hiram Burgess
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Georgia Ann McLellan
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Leighton S. Burgess
address 8 Ford Street, ________?, NH
Relationship to deceased Son
21. Place of burial Walton, Hants Co., NS
Date of burial 23 September 1971
22. Undertaker J. Wilson Allen, Summerville, Hants Co., NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 20, 1971
CAUSE OF DEATH
(a) Coronary Artery Occlusion & Myocardial Infarction
(b)
(c) Arteriosclerosis
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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