Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clifford Roy Wagner death at Berwick, Kings County on March 25, 1970
Male Death Registration: Year: 1970 number: 2782
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002782
1. PLACE OF DEATH County of Kings If in City or Town Berwick
If death occured in a hospital or institution Western Kings Memorial Hospital
3. PRINT NAME OF DECEASED Wagner, Clifford Roy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Annapilis Royal
9. DATE OF BIRTH 10 14, 1891
10. AGE in Years78 Months5 Days11 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Sarah Burns
16. NAME of Father Elizah Wagner
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Sophia Hubley
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs Sarah Wagner
address Berwick West
Relationship to deceased Wife
21. Place of burial Berwuck
Date of burial March 28 1970
22. Undertaker H.C. Lindsay Funeral Homes Ltd. Kentville
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 25, 1970
CAUSE OF DEATH
(a)
(b)
(c)
other
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