Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Derek Wayne Allen death at Amherst, Cumberland County on January 17, 1971
Male Death Registration: Year: 1971 number: 1404
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001404
1. PLACE OF DEATH County of Cumberland If in City or Town Amherst
If death occured in a hospital or institution Highland View Hospital
3. PRINT NAME OF DECEASED Allen, Derek Wayne
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Amherst
9. DATE OF BIRTH 6 13, 1949
10. AGE in Years21 Months7 Days4 | hrs or mins
11. Trade or profession Member of the Armed Forces (Navy)
12. Kind of industry
13. Date last worked to date 14. Total years 4 1/2 yrs
15. If married name of spouse Sharron J. Allen
16. NAME of Father Ivan B. Allen
17. BIRTHPLACE Cumb. Co.
18. NAME of Mother Geraldine M. Crossman
19. BIRTHPLACE Cumb. Co.
20. Signature of Informant Ivan B. Allen
address 63 West Victoria St., Amherst
Relationship to deceased Father
21. Place of burial Amherst Cemetery Co., Amherst
Date of burial January 20, 1971
22. Undertaker Furlong's Funeral Home Ltd., Amherst
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 17, 1971
CAUSE OF DEATH
(a) Massive brain damage as a result of gun shot wound into his head
(b)
(c)
other
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