Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Michael Ellsworth death at Halifax, Halifax County on July 8, 1970
Male Death Registration: Year: 1970 number: 4259
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004259
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Camp Hill Hospital
3. PRINT NAME OF DECEASED Ellsworth, Michael
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Irish
7. Single, Married
single
8. BIRTHPLACE New Glasgow
9. DATE OF BIRTH 11 28, 1889
10. AGE in Years80 Months7 Days10 | hrs or mins
11. Trade or profession Miner (Retired)
12. Kind of industry Coal Mining.
13. Date last worked 1952 14. Total years 43
15. If married name of spouse N.A.
16. NAME of Father James Ellsworth.
17. BIRTHPLACE Cape Breton
18. NAME of Mother Mary McDougall
19. BIRTHPLACE Cape Breton
20. Signature of Informant Annie Ellsworth
address 58 Junction Rd. Springhill
Relationship to deceased Sister.
21. Place of burial Springhill
Date of burial July 11th 1970
22. Undertaker A.H. Brown Funeral Service Ltd., Springhill
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 8, 1970
CAUSE OF DEATH
(a) Broncho pneumonia
(b)
(c)
other old C.V.A - arteriosclerosis
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