Male Death Registration: Year: 1971 number: 1875
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001875
1. PLACE OF DEATH County of Colchester If in City or Town Truro
If death occured in a hospital or institution Colchester Co. Hospital
3. PRINT NAME OF DECEASED Withrow, Chalmers
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 2 14, 1881
10. AGE in Years90 Months Days1 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Farming
13. Date last worked 14. Total years Life
15. If married name of spouse Mary Withrow
16. NAME of Father Reuben Withrow
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Annie Dodd
19. BIRTHPLACE Scotland
20. Signature of Informant Mary Withrow
address Nova Scotia
Relationship to deceased wife
21. Place of burial Shubenacadie, N. S.
Date of burial 18 Feb 1971
22. Undertaker Ettinger Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 15, 1971
CAUSE OF DEATH
(a) hypostatic pneumonia, 5 days
(b) Arteriosclerotic heart failure
(c) cerebral arteriosclerosis
other Fractured neck (R) femur, 70 days
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=493953
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