Male Death Registration: Year: 1970 number: 4088
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004088
1. PLACE OF DEATH County of Pictou If in City or Town New Glasgow
If death occured in a hospital or institution Aberdeen Hospital
3. PRINT NAME OF DECEASED Smith, Ellis Edwin
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Massachusetts, USA
9. DATE OF BIRTH 5 18, 1906
10. AGE in Years64 Months0 Days27 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Mechanic
13. Date last worked 1962 14. Total years Life
15. If married name of spouse
16. NAME of Father Edward Smith
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Hattie Robertson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant George Ross
address IOOF Home, Pictou
Relationship to deceased None
21. Place of burial Malagash
Date of burial June 18, 1970
22. Undertaker McLaren Funeral Home, Pictou
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 14, 1970
CAUSE OF DEATH
(a) Carcinoma Stomach
(b)
(c)
other Gangrene Rt leg Arterosclerotic cerebrovascular disease
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=489397
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