Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clifford George Williams death at Halifax, Halifax County on June 28, 1971
Male Death Registration: Year: 1971 number: 4099
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004099
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Camp Hill Hospital, Halifax, NS
3. PRINT NAME OF DECEASED Williams, Clifford George
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Ostrea Lake, Halifax County
9. DATE OF BIRTH 9 7, 1898
10. AGE in Years72 Months9 Days21 | hrs or mins
11. Trade or profession Retired Sea Captain
12. Kind of industry Department of Transport
13. Date last worked 1962 14. Total years 40 yrs
15. If married name of spouse Kathleen Williams
16. NAME of Father Michael Williams
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Ellen Bowser
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Kathleen Williams
address 33 Thistle St, Dartmouth
Relationship to deceased Wife
21. Place of burial Mt. Hermon, Dartmouth
Date of burial July 1, 1971
22. Undertaker Mattatall Funeral Services Ltd., Dartmouth, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 28, 1971
CAUSE OF DEATH
(a) Perforated Duodenal Ulcer
(b) Duodenal Ulcer
(c)
other Peritonitis
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