Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles Franklin Corkum death at Upper Burlington, Hants County on December 4, 1971
Male Death Registration: Year: 1971 number: 7068
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007068
1. PLACE OF DEATH County of Hants If in City or Town Upper Burlington
If death occured in a hospital or institution Upper Burlington, Hants Co.
3. PRINT NAME OF DECEASED Corkum, Charles Franklin
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Dutch
7. Single, Married
divorced
8. BIRTHPLACE Chester
9. DATE OF BIRTH , 1895
10. AGE in Years76 Months Days | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Robert Corkum
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Mary Corkum
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Len Rudolph
address Sackville, Halifax Co.
Relationship to deceased Nephew
21. Place of burial Maplewood, Windsor
Date of burial Dec. 8, 1971
22. Undertaker R. D. Lindsay, Windsor
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 4, 1971
CAUSE OF DEATH
(a) Crushing injury to chest
(b) Motor vehicle accident
(c)
other
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