Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Samuel Clifford MacKenzie death at Halifax, Halifax County on January 29, 1971
Male Death Registration: Year: 1971 number: 1417
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001417
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Camp Hill Hospital
3. PRINT NAME OF DECEASED MacKenzie, Samuel Clifford
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 1 26, 1896
10. AGE in Years75 Months Days3 | hrs or mins
11. Trade or profession Retired Cook
12. Kind of industry At Dart.
13. Date last worked Jan. 1965 14. Total years 25
15. If married name of spouse Elsie Marie MacKenzie
16. NAME of Father John MacKenzie
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Anna McMichael
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Elsie MacKennie
address 8 Kiwanis Park, Dartmouth
Relationship to deceased Wife
21. Place of burial Gays River
Date of burial February 1, 1971
22. Undertaker Dartmouth Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 29, 1971
CAUSE OF DEATH
(a) Congestive Heart Failure
(b) Cerebro-Vascular Accident
(c)
other
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