Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Willard Douglas Melvin death at Halifax, Halifax County on July 9, 1971
Male Death Registration: Year: 1971 number: 4356
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004356
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Keddy's Nursing Manor
3. PRINT NAME OF DECEASED Melvin, Willard Douglas
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 6 30, 1892
10. AGE in Years79 Months Days9 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Daniel Melvin
17. BIRTHPLACE
18. NAME of Mother Martha
19. BIRTHPLACE
20. Signature of Informant Mr. John Melvin
address Deep River, Ont.
Relationship to deceased Son
21. Place of burial Camp Hill, Hfx, NS
Date of burial July 12, 1971
22. Undertaker Snow & Co. Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 9, 1971
CAUSE OF DEATH
(a) Cerebral Thrombosis
(b) Arteriosclerosis
(c)
other
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