Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Shawn David Rose death at North Sydney, Cape Breton County on December 6, 1971
Male Death Registration: Year: 1971 number: 7042
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007042
1. PLACE OF DEATH County of Cape Breton If in City or Town North Sydney
If death occured in a hospital or institution St. Elizabeth Hospital
3. PRINT NAME OF DECEASED Rose, Shawn David
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE North Sydney
9. DATE OF BIRTH 10 22, 1971
10. AGE in Years Months1 Days14 | hrs or mins
11. Trade or profession Infant
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father James Charles Rose
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Wilma Galpin
19. BIRTHPLACE Nova Scotia
20. Signature of Informant James Charles Rose
address 34 Clearyville St., North Sydney
Relationship to deceased Father
21. Place of burial Lakeside Cemetery, North Sydney
Date of burial December 7, 1971
22. Undertaker Fillmore & Whitman Funeral Home Ltd., North Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 6, 1971
CAUSE OF DEATH
(a) Regurcitation
(b) Dead on arrival O.P. Dept. St. Elizabeth
(c)
other
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