Nova Scotia Archives

Nova Scotia Births, Marriages, and Deaths

Hearn death at Halifax, Halifax County on May 22, 1971

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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