Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Adam Charlton death at Halifax, Halifax County on December 3, 1971
Male Death Registration: Year: 1971 number: 7016
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007016
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Victoria General Hospital
3. PRINT NAME OF DECEASED Charlton, John Adam
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Saint John, New Brunswick
9. DATE OF BIRTH 4 12, 1921
10. AGE in Years50 Months7 Days21 | hrs or mins
11. Trade or profession Salesman
12. Kind of industry Insurance
13. Date last worked 1970 14. Total years 5 years
15. If married name of spouse Helen Charlton
16. NAME of Father William Charlton
17. BIRTHPLACE New Brunswick
18. NAME of Mother Rowena Brayley
19. BIRTHPLACE New Brunswick
20. Signature of Informant Mrs. Helen Charlton
address 205 Crichton Ave. Dartmouth
Relationship to deceased Wife
21. Place of burial Hillcrest Memorial Gardens, Dartmouth
Date of burial December 6, 1971
22. Undertaker Mattatall Funeral Services Ltd. Dartmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 3, 1971
CAUSE OF DEATH
(a) Septic Coma
(b) Heart Failure
(c)
other
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