Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Smith Asa Nickerson death at Centreville, Shelburne County on May 27, 1970
Male Death Registration: Year: 1970 number: 3648
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003648
1. PLACE OF DEATH County of Shelburne If in City or Town Centreville
If death occured in a hospital or institution Secondary Carcinoma
3. PRINT NAME OF DECEASED Nickerson, Smith Asa
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 6 10, 1901
10. AGE in Years68 Months11 Days17 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked 1968 14. Total years 40
15. If married name of spouse Edith Nickerson
16. NAME of Father Charles Nickerson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Selena Nickerson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Eugene Nickerson
address Clarks Harbour
Relationship to deceased Son
21. Place of burial Clarks Harbour
Date of burial May 31 1970
22. Undertaker Kenney Funeral Services, Barrington, Shel. Co.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 27, 1970
CAUSE OF DEATH
(a) Carcinoma of Left Lung (excised)
(b)
(c)
other
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