Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Carlton Erwin Kellum death at Halifax, Halifax County on July 25, 1971
Male Death Registration: Year: 1971 number: 4870
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004870
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Grace Maternity Hospital
3. PRINT NAME OF DECEASED Kellum, Carlton Erwin
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
African
7. Single, Married
single
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 7 18, 1971
10. AGE in Years Months Days7 | 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 Elizabeth Kellum
19. BIRTHPLACE Halifax, NS
20. Signature of Informant Medical Records
address Grace Maternity Hospital
Relationship to deceased
21. Place of burial Hospital Burial
Date of burial
22. Undertaker
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 25, 1971
CAUSE OF DEATH
(a) Congenital Malformation and Congenital Heart Disease (Trosomy 18)
(b)
(c)
other
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Note: African Nova Scotian