Male Death Registration: Year: 1971 number: 6496
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006496
1. PLACE OF DEATH County of Pictou If in City or Town Riverton
If death occured in a hospital or institution Pictou County Home for the Aged
3. PRINT NAME OF DECEASED MacKenzie, Samuel
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Gairloch, Pictou County
9. DATE OF BIRTH 3 14, 1881
10. AGE in Years90 Months7 Days13 | hrs or mins
11. Trade or profession Farmer
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Alexander MacKenzie
17. BIRTHPLACE
18. NAME of Mother Bessie Fraser
19. BIRTHPLACE
20. Signature of Informant Kenneth MacLean
address RR #1, Stellarton, NS
Relationship to deceased Superintendent, Pictou County Home for the Aged
21. Place of burial Gairloch Cemetery, Pictou Co., NS
Date of burial 29 October 1971
22. Undertaker Eagles Funeral Home, Westville, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 27, 1971
CAUSE OF DEATH
(a) Carcinomatosis
(b) Cancer of Prostate
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=498569
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