Male Death Registration: Year: 1971 number: 7136
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007136
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution 6387 Summit
3. PRINT NAME OF DECEASED Jackson, David Alan
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 11 7, 1945
10. AGE in Years26 Months1 Days3 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry Dept. of Highways
13. Date last worked October 1971 14. Total years 1 mon
15. If married name of spouse
16. NAME of Father A.R. Jackson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Dorthy Rawlings
19. BIRTHPLACE N.B.
20. Signature of Informant A.R. Jackson
address 6387 Summit St., Halifax
Relationship to deceased Father
21. Place of burial Fairview, Hfx.
Date of burial December 13, 1971
22. Undertaker Halifax Funeral Home Limited
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 10, 1971
CAUSE OF DEATH
(a) Bullet wound through head
(b)
(c)
other Mental depression
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=499208
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