Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Samuel Gromack death at Glace Bay, Cape Breton County on August 23, 1971
Male Death Registration: Year: 1971 number: 7034
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007034
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution St. Joseph's Hospital
3. PRINT NAME OF DECEASED Gromack, Samuel
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Polish
7. Single, Married
married
8. BIRTHPLACE Romania
9. DATE OF BIRTH 9 1, 1893
10. AGE in Years77 Months11 Days22 | hrs or mins
11. Trade or profession Miner
12. Kind of industry Dom. Coal Co.
13. Date last worked 14. Total years 43
15. If married name of spouse Mary Flolek
16. NAME of Father John Jacobe
17. BIRTHPLACE Romania
18. NAME of Mother Marie Calistral
19. BIRTHPLACE Romania
20. Signature of Informant Joe Gromack
address 22 Phalen Rd., Glace Bay
Relationship to deceased Son
21. Place of burial St. Johns Cem., Glace Bay
Date of burial August 26, 1971
22. Undertaker Curry's Funeral Home, Glace Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 23, 1971
CAUSE OF DEATH
(a) Coronary Thrombosis
(b) C. Thrombosis (Jan 71)
(c)
other
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