Male Death Registration: Year: 1971 number: 5065
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005065
1. PLACE OF DEATH County of Pictou If in City or Town Riverton
If death occured in a hospital or institution County Home
3. PRINT NAME OF DECEASED Sellers, Lewis Wallace
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE River John
9. DATE OF BIRTH 7 27, 1897
10. AGE in Years74 Months Days13 | hrs or mins
11. Trade or profession Retired Farmer
12. Kind of industry Dairy
13. Date last worked 1967 14. Total years 47 yrs
15. If married name of spouse Ida Sellers
16. NAME of Father James Sellers
17. BIRTHPLACE River John, NS
18. NAME of Mother Aseneth MacLeod
19. BIRTHPLACE River John, NS
20. Signature of Informant Ida Sellers
address RR#4,River John, NS
Relationship to deceased Wife
21. Place of burial River John, NS
Date of burial August 11, 1971
22. Undertaker MacLeod's Funeral Service, River John, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 9, 1971
CAUSE OF DEATH
(a) Myocardial Infarction
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=497139
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