OntarioGenWeb
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Ontario Vital Statistics Death Registration Form
1912/3+
   
Microfilm #    
Registration #    
County    
Division    
Full Name of Deceased    
Sex    
Age     
Date of Death    
Place of Birth    
Place of Death    
Occupation    
Single, Married or Widowed    
Name of Father    
Maiden Name of Mother    
Cause of Death, if known    
Name of Physician    
Name of Informant    
Address    
Date of Return    
  Physician's Return of Death Physician's Return of Death
Christian Name     
Date of Death    
Disease Causing Death    
Duration    
Immediate Cause of Death    
Duration    
Physician's Name    
Address    
Date of Return    
   
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