Male Death Registration: Year: 1970 number: 1194
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001194
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Izaak Walton Killam Hospital
3. PRINT NAME OF DECEASED Gauthier, Kevin Lee
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Amherst
9. DATE OF BIRTH 1 4, 1970
10. AGE in Years Months Days5 | hrs or mins
11. Trade or profession Infant
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Ronald Gauthier
17. BIRTHPLACE Bathurst, New Brunswick
18. NAME of Mother Nancy Johnson
19. BIRTHPLACE Amherst
20. Signature of Informant Ronald Gauthier
address 12 James St., Amherst
Relationship to deceased Father
21. Place of burial Highland, Amherst
Date of burial Jan. 11, 1970
22. Undertaker Campbells’s Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 9, 1970
CAUSE OF DEATH
(a) Respiratory Distress Syndrome
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=486508
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