Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Pearl Christina Davis death at Shelburne, Shelburne County on December 17, 1971
Female Death Registration: Year: 1971 number: 7604
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007604
1. PLACE OF DEATH County of Shelburne If in City or Town Shelburne
If death occured in a hospital or institution Prince Street, Shelburne
3. PRINT NAME OF DECEASED Davis, Pearl Christina
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Negro
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 12 29, 1911
10. AGE in Years59 Months11 Days18 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry
13. Date last worked 1971 14. Total years 40 years
15. If married name of spouse Walter Davis
16. NAME of Father Otis Farmer
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Cora Wilson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Kenneth Smith
address Shelburne, Nova Scotia
Relationship to deceased Daughter
21. Place of burial Pine Grove Cemetery, Shelburne
Date of burial 20 December 1971
22. Undertaker Huskilson's Funeral Home, Shelburne
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 17, 1971
CAUSE OF DEATH
(a) Myocardial Infarction
(b) Myocardial Ischemia
(c) Previous Infarction
other
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