Male Death Registration: Year: 1970 number: 5183
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005183
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Isaac Walton Killam Hospital for Children
3. PRINT NAME OF DECEASED Roulston, George Robert Andrew
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Sackville, New Brunswick
9. DATE OF BIRTH 1 23, 1957
10. AGE in Years13 Months5 Days21 | hrs or mins
11. Trade or profession Student
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Maxwell Roulston
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Emelie Church
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Maxwell Roulston
address Fletchers Lake
Relationship to deceased Father
21. Place of burial Fall River Cemetery
Date of burial August 17, 1970
22. Undertaker Lindsays Bedford
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 13, 1970
CAUSE OF DEATH
(a) Cerebral Hemorrhage
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=490491
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