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 | Odd Carl Sundt Backe-Hansen (1919-1963) - Death Certificate (South Africa, Civil Death Registration, 1955-1966)
Form of Information of a Death - Aangifte van ‘n Sterfgeval
Deceased - Oorledene
1) Identity Number: 211-595109 w
2) Surname: Backe-Hansen
3) First Names: Odd Carl Sundt
4) Date of Death: Thirtieth of July 1963
5) Sex: Male
6) Place of Death: Sanatorium, Durban
7) Race: White
8) Age and Date of Birth: 49 years, 18-2-1914
9) Single, Married, Divorced, Widower or Widow: Married
10) Occupation: Broker, Self Employed
11) Pensioner or Recepient of Maintenance Allowance…: No
12) Causes of Death: Adeno Carcinoma Stomach, Hypostatic Pneumonia
13) Duration of Disease or of Last Illness: Two months, one week
14) Name of Medical Practitioner: Dr. J. A. Davidson
15) Place of Birth of Deceased: Durban, Natal
16) Residential Address of Deceased: 56 Roslyn, St. Andrews Street, Durban
17) Intended Place of Burial: Crematorium Stellawood, Durban
Informant - Beriggewer
17) Original Signature (or Mark): Walter G. Dave
18) Qualification: Person Causing Burial
19) Residential Address: 28 Berea Rd., Durban
Date: 15-7-1963, Durban |
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