Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
David Sylvester Jackson death at Sydney, Cape Breton County on January 5, 1970
Male Death Registration: Year: 1970 number: 1136
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001136
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution Sydney City Hospital, Sydney
3. PRINT NAME OF DECEASED Jackson, David Sylvester
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Ingonish
9. DATE OF BIRTH 9 5, 1900
10. AGE in Years69 Months4 Days | hrs or mins
11. Trade or profession Marine engineer
12. Kind of industry Dominion Coal Co.
13. Date last worked 1965 14. Total years 45
15. If married name of spouse
16. NAME of Father Godfrey Jackson
17. BIRTHPLACE Ingonish
18. NAME of Mother Margaret Gillis
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Wilfred Jackson
address 1403 Victoria Rd., Sydney
Relationship to deceased Brother
21. Place of burial Resurrection Cemetery, Sydney Forks
Date of burial January 8, 1970
22. Undertaker T.W. Curry, Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 5, 1970
CAUSE OF DEATH
(a) Endothelioma of Pleura
(b)
(c)
other
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