Nova Scotia Archives

Nova Scotia Births, Marriages, and Deaths

Harry Zawalak death at Halifax, Halifax County on May 2, 1971

Male Death Registration: Year: 1971 number: 3129

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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH

02 - 003129

1. PLACE OF DEATH   County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary

3. PRINT NAME OF DECEASED Zawalak, Harry

4. Sex

Male

5. Citizenship

6. Racial Origin

Polish

7. Single, Married

widowed

8. BIRTHPLACE Poland Austerian

9. DATE OF BIRTH 12  , 1880

10. AGE in  Years90  Months4  Days3 | hrs or mins

11. Trade or profession Retired

12. Kind of industry Carpenter

13. Date last worked 1960       14. Total years life

15. If married name of spouse Annie Zawalak (deceased)

16. NAME of Father Andrew Zawalak

17. BIRTHPLACE Austeria

18. NAME of Mother  

19. BIRTHPLACE

20. Signature of Informant Mrs. Joseph Chaban

      address 3419 Albert Street, Halifax

      Relationship to deceased Step-daughter

21. Place of burial Gates of Heaven, Lr. Sackville

      Date of burial May 5, 1971

22. Undertaker Cruikshank Funeral Home Limited

MEDICAL CERTIFICATE OF DEATH

23. DATE OF DEATH May 2, 1971

CAUSE OF DEATH

(a) Arteriosclerotic Heart disease

(b) Congestive Heart Failure

(c)

other Chronic Obstructive Airway Disease Chronic Brain Syndrome

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