Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
LeRoy Ellsworth Wagner death at Halifax, Halifax County on January 13, 1971
Male Death Registration: Year: 1971 number: 1184
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001184
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Aortic Stenosis
3. PRINT NAME OF DECEASED Wagner, LeRoy Ellsworth
4. Sex
Male
5. Citizenship
canadian
6. Racial Origin
Anglo-Saxon
7. Single, Married
married
8. BIRTHPLACE Bear River
9. DATE OF BIRTH 10 21, 1939
10. AGE in Years31 Months2 Days23 | hrs or mins
11. Trade or profession Forest Ranger
12. Kind of industry Department of Lands and Forests
13. Date last worked 1971 14. Total years 8 years
15. If married name of spouse Heather Schell
16. NAME of Father Roy Wagner
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Eva Darres
19. BIRTHPLACE Nova Scotia
20. Signature of Informant
address
Relationship to deceased
21. Place of burial Mount Hope Cemetery, Bear River, Nova Scotia
Date of burial January 15 1971
22. Undertaker Jayne's Funeral Home Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 13, 1971
CAUSE OF DEATH
(a)
(b)
(c)
other
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