Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Evelyn Marion Blackett death at Halifax, Halifax County on January 21, 1971
Female Death Registration: Year: 1971 number: 1305
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001305
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution 5680 Victoria Road, Halifax
3. PRINT NAME OF DECEASED Blackett, Evelyn Marion
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Prince Edward Island
9. DATE OF BIRTH 3 10, 1913
10. AGE in Years57 Months10 Days11 | hrs or mins
11. Trade or profession Supervisor
12. Kind of industry Camp Hill Hospital
13. Date last worked 19 Jan '71 14. Total years 20
15. If married name of spouse
16. NAME of Father James Blackett
17. BIRTHPLACE P.E.I.
18. NAME of Mother Jessie Wilt
19. BIRTHPLACE P.E.I.
20. Signature of Informant Miss Gaile Harding
address 2564 Elm St., Halifax
Relationship to deceased Niece
21. Place of burial St. James Church Cemetery, Charlottetown, P.E.I.
Date of burial January 25, 1971
22. Undertaker Ettinger Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 21, 1971
CAUSE OF DEATH
(a) Ac Myocardial infarction
(b)
(c) arteriosclerosis
other
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