Male Death Registration: Year: 1971 number: 1325
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001325
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary Hospital
3. PRINT NAME OF DECEASED Wagner, Colin Roger
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Caucasian
7. Single, Married
married
8. BIRTHPLACE Lunenburg County
9. DATE OF BIRTH 12 8, 1917
10. AGE in Years53 Months1 Days18 | hrs or mins
11. Trade or profession Carpenter and Truck Driver
12. Kind of industry
13. Date last worked 1969 14. Total years 30
15. If married name of spouse Mrs. Elsie Wagner
16. NAME of Father Jerimah Wagner
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Theresa Mosher
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. I. Finlayson
address Middleton, RR#3
Relationship to deceased Daughter
21. Place of burial Nictaux
Date of burial January 30, 1971
22. Undertaker Frederick H. Roop Funeral Service, Middleton
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 26, 1971
CAUSE OF DEATH
(a) Mesothelioma
(b) Metastases in lungs
(c)
other Phlebothrombosis Pleural Effusion
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=493403
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