Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles Henry Smith death at Halifax, Halifax County on January 4, 1971
Male Death Registration: Year: 1971 number: 1023
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001023
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Civic Hospital
3. PRINT NAME OF DECEASED Smith, Charles Henry
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 9 6, 1890
10. AGE in Years80 Months3 Days29 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Imperoyal
13. Date last worked 1950 14. Total years 20
15. If married name of spouse
16. NAME of Father Charles Smith
17. BIRTHPLACE England
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Aubrey Smith
address Eastern Passage, Box 132
Relationship to deceased Son
21. Place of burial Mt. Hermon Cem., Dart.
Date of burial January 7, 1971
22. Undertaker A. L. Mattatall Fun. Serv. Ltd., Dartmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 4, 1971
CAUSE OF DEATH
(a) Arterosclerotic Heart Disease
(b)
(c) Cerebral Arterosclerosis
other Diabetes Mellitus Chronic Bronchitis
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