Male Death Registration: Year: 1971 number: 6929
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006929
1. PLACE OF DEATH County of Digby If in City or Town Digby
If death occured in a hospital or institution Digby General Hospital
3. PRINT NAME OF DECEASED Potter, Harold Ambrose Ross
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Plympton, Digby County
9. DATE OF BIRTH 8 15, 1891
10. AGE in Years80 Months2 Days29 | hrs or mins
11. Trade or profession Retired Millwright
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father George Potter
17. BIRTHPLACE NS
18. NAME of Mother Orilla Harris
19. BIRTHPLACE NS
20. Signature of Informant E. Carolyn Brown
address Digby, NS
Relationship to deceased Niece
21. Place of burial Bear River, Digby Co., NS
Date of burial 16 November 1971
22. Undertaker Jayne's Funeral Home Ltd., Digby, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 13, 1971
CAUSE OF DEATH
(a) Arteriosclerosis
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=499002
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