Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Camp death at Halifax, Halifax County on July 28, 1971
Male Death Registration: Year: 1971 number: 4872
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004872
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 Camp,
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 7 28, 1971
10. AGE in Years Months Days | 2 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 William Camp
17. BIRTHPLACE St. Johns, Newfoundland
18. NAME of Mother Marilyn Riley
19. BIRTHPLACE Winnipeg, Manitoba
20. Signature of Informant William S. Camp
address Port Aux Basques, Nfld.
Relationship to deceased Father
21. Place of burial Hosp. Burial
Date of burial
22. Undertaker
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 28, 1971
CAUSE OF DEATH
(a) Prematurity
(b)
(c)
other
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