Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Wallace Wilson Wagner death at Simpsons Corner, Lunenburg County on January 16, 1971
Male Death Registration: Year: 1971 number: 1148
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001148
1. PLACE OF DEATH County of Lunenburg If in City or Town Simpsons Corner
If death occured in a hospital or institution At Home
3. PRINT NAME OF DECEASED Wagner, Wallace Wilson
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 1 1, 1895
10. AGE in Years76 Months Days15 | hrs or mins
11. Trade or profession Farmer
12. Kind of industry
13. Date last worked 1971 14. Total years 48
15. If married name of spouse Mrs. Hilda Wagner
16. NAME of Father Caleb Wagner
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Matilda Falkenham
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Hilda Wagner
address Simpson's Corner
Relationship to deceased Wife
21. Place of burial Ninevah
Date of burial January 18, 1971
22. Undertaker Langille's Funeral Home, Barss Corner
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 16, 1971
CAUSE OF DEATH
(a) C.V. Accident
(b) arteriosclerosis
(c) hypertension
other
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