Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles Burton Wallace death at Shubenacadie, Hants County on September 5, 1970
Male Death Registration: Year: 1970 number: 5517
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005517
1. PLACE OF DEATH County of Hants If in City or Town Shubenacadie
3. PRINT NAME OF DECEASED Wallace, Charles Burton
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish and English
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 12 4, 1900
10. AGE in Years69 Months9 Days1 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Labourer
13. Date last worked 1950 14. Total years Life
15. If married name of spouse
16. NAME of Father James Burton Wallace
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Catherine Moxsom
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Howard Wallace
address Shubenacadie
Relationship to deceased Brother
21. Place of burial Mill Village
Date of burial September 8, 1970
22. Undertaker Ettinger Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 5, 1970
CAUSE OF DEATH
(a) Coronary Thrombosis
(b)
(c)
other
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