Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Earl Douglas Ellis death at Halifax, Halifax County on October 18, 1970
Male Death Registration: Year: 1970 number: 6234
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006234
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 Ellis, Earl Douglas
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE New Brunswick
9. DATE OF BIRTH 10 31, 1900
10. AGE in Years69 Months11 Days14 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Lillian Ells (Mombourquetete)
16. NAME of Father James MacEwan Ellis
17. BIRTHPLACE New Brunswick
18. NAME of Mother Margaret
19. BIRTHPLACE New Brunswick
20. Signature of Informant Joseph Mombourquett
address West : L'Ardoise
Relationship to deceased Stepson
21. Place of burial L'Ardoise R.C. Cemetery
Date of burial October 22 1970
22. Undertaker Alex A. Morrison
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 18, 1970
CAUSE OF DEATH
(a) Myocardial Infraction
(b) Arteriosclerotic Heart Disease
(c)
other
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