Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Paul Gordon Gillis death at Halifax, Halifax County on December 17, 1971
Male Death Registration: Year: 1971 number: 7265
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007265
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution I.W. Killam Hospital for Children
3. PRINT NAME OF DECEASED Gillis, Paul Gordon
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Caucasian
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 22, 1961
10. AGE in Years10 Months2 Days25 | 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 Gordon H.K. Gillis
17. BIRTHPLACE Halifax, Nova Scotia
18. NAME of Mother John Cunningham
19. BIRTHPLACE Ship Harbour, Nova Scotia
20. Signature of Informant Mrs. Gillis
address 240 Alexandra Avenue, Bridgewater, NS
Relationship to deceased Father
21. Place of burial Bridgewater, NS
Date of burial December 14, 1971
22. Undertaker C.F. Sweeney Funeral Home Ltd., Bridgewater
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 17, 1971
CAUSE OF DEATH
(a) Dislocated neck and brain injuries due to car - pedestrian accident
(b)
(c)
other
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