Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Baby Boy Smith death at Halifax, Halifax County on July 23, 1971
Male Death Registration: Year: 1971 number: 4608
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004608
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Izaak Walton Killam Hospital for Children
3. PRINT NAME OF DECEASED Smith, Baby Boy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 7 19, 1971
10. AGE in Years Months Days4 | 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
17. BIRTHPLACE
18. NAME of Mother Jean Smith
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. James Smith
address 57 River Rd, Halifax, NS
Relationship to deceased Grandmother
21. Place of burial Holy Cross, NS
Date of burial July 26, 1971
22. Undertaker Halifax Funeral Home, Halifax, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 23, 1971
CAUSE OF DEATH
(a) Respiratory Distress Syndrome
(b) Peritonitis
(c)
other Possible Intraventricular Hemorrhage
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