Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Simon Osborne MacDonald death at Halifax, Halifax County on October 22, 1971
Male Death Registration: Year: 1971 number: 6423
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006423
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Victoria General Hospital, Halifax
3. PRINT NAME OF DECEASED MacDonald, Simon Osborne
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
White
7. Single, Married
married
8. BIRTHPLACE Springville, Pictou County
9. DATE OF BIRTH 11 15, 1895
10. AGE in Years75 Months11 Days2 | hrs or mins
11. Trade or profession Retired Inspector
12. Kind of industry Provincial Dept. of Public Works
13. Date last worked 14. Total years
15. If married name of spouse Jessie Taylor
16. NAME of Father Simon MacDonald
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Jennie MacGregor
19. BIRTHPLACE Nova Scotia
20. Signature of Informant D. Eileen Rafuse
address 143 York Street, Bridgewater, Lunenburg Co., NS
Relationship to deceased Daughter
21. Place of burial Springville, Pictou Co., NS
Date of burial 24 October 1971
22. Undertaker R. H. Porter Funeral Homes Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 22, 1971
CAUSE OF DEATH
(a) Prostatic Carcinoma
(b) Arteriosclerotic Heart Disease with possible Shock
(c)
other ? Pneumonia
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