Male Death Registration: Year: 1970 number: 4884
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004884
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Victoria General Hospital
3. PRINT NAME OF DECEASED Smith, Daniel Havelock
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Hammonds Plains
9. DATE OF BIRTH 1 1, 1886
10. AGE in Years84 Months7 Days13 | hrs or mins
11. Trade or profession Retired Cooper
12. Kind of industry Lumber
13. Date last worked 1960 14. Total years 50 years
15. If married name of spouse Late Sadie Smith
16. NAME of Father Henry Smith
17. BIRTHPLACE Hammonds Plains
18. NAME of Mother Louise Mason
19. BIRTHPLACE Head St. Margarets Bay
20. Signature of Informant Blanche Munroe
address Hammonds Plains
Relationship to deceased Daughter
21. Place of burial Baptist Cemetery, Hammonds Plains
Date of burial 17 August 1970
22. Undertaker Cruikshank Funeral Home Ltd, Halifax
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 14, 1970
CAUSE OF DEATH
(a) Myocardial Infarction
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=490193
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