Male Death Registration: Year: 1970 number: 5832
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005832
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 Simmons, Frederick William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE St. John, New Brunswick
9. DATE OF BIRTH 11 12, 1890
10. AGE in Years79 Months7 Days15 | hrs or mins
11. Trade or profession retired
12. Kind of industry checker
13. Date last worked 1960 14. Total years 10
15. If married name of spouse Clendon Simmons
16. NAME of Father Frederick Simmons
17. BIRTHPLACE St. John, New Brunswick
18. NAME of Mother Louise Webb
19. BIRTHPLACE England
20. Signature of Informant George Simmons
address East Riverside, New Brunswick
Relationship to deceased Brother
21. Place of burial Fernhill Crematorium
Date of burial June 30, 1970
22. Undertaker Cruikshank Funeral Home Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 27, 1970
CAUSE OF DEATH
(a) Bilateral Broncho pneumonia
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=491140
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