Male Death Registration: Year: 1971 number: 5857
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005857
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Civic Hospital
3. PRINT NAME OF DECEASED Wallace, Harry Croffort
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 2 16, 1891
10. AGE in Years80 Months7 Days19 | 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 Charles Wallace
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Annie Balcom
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mr. Douglas Wallace
address 6162 South St Halifax NS
Relationship to deceased Brother
21. Place of burial (?) Hfx
Date of burial Oct 7, 1971
22. Undertaker Snow & Co Ltd, Hfx
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 5, 1971
CAUSE OF DEATH
(a) Myocardial infarct
(b) Cor pulmonale
(c)
other Parkinsonism
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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