Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
William Andrew Backa death at Springhill, Cumberland County on November 16, 1970
Male Death Registration: Year: 1970 number: 6694
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006694
1. PLACE OF DEATH County of Cumberland If in City or Town Springhill
If death occured in a hospital or institution Friend's home
3. PRINT NAME OF DECEASED Backa, William Andrew
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Czechoslovakian
7. Single, Married
single
8. BIRTHPLACE Springhill
9. DATE OF BIRTH 3 8, 1945
10. AGE in Years25 Months8 Days8 | hrs or mins
11. Trade or profession Stationary Engineer
12. Kind of industry Hospital Boiler Room
13. Date last worked Nov 15, 1970 14. Total years 2
15. If married name of spouse
16. NAME of Father Andrew Backa
17. BIRTHPLACE Czechoslovakia
18. NAME of Mother Anna Konkus
19. BIRTHPLACE Czechoslovakia
20. Signature of Informant John F Backa
address 47 Churchill Dr, Apmt 31, Dartmouth
Relationship to deceased Brother
21. Place of burial Springhill
Date of burial November 19 1970
22. Undertaker A.H. Brown Funeral Service Ltd., Springhill
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 16, 1970
CAUSE OF DEATH
(a) Crushing injury to chest with Asphyxiation
(b)
(c)
other Accident - car jack dropped car on chest
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