Male Death Registration: Year: 1971 number: 5966
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005966
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Izaak Walton Killam Hospital
3. PRINT NAME OF DECEASED Hearn,
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Digby
9. DATE OF BIRTH 5 17, 1971
10. AGE in Years Months Days5 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father William Hearn
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Diana E. Cook
19. BIRTHPLACE Bear River
20. Signature of Informant A.D. Vasey
address I.W.K. Hospital, Halifax
Relationship to deceased Physician taking care of patient
21. Place of burial Hospital burial Halifax
Date of burial May 22, 1971
22. Undertaker Hospital Burial
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 22, 1971
CAUSE OF DEATH
(a) Meningitis
(b) Prematurity
(c)
other Shock
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=498040
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