Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Wayne Theriault death at Lawrencetown, Halifax County on June 9, 1970
Male Death Registration: Year: 1970 number: 3730
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003730
1. PLACE OF DEATH County of Halifax If in City or Town Lawrencetown
If death occured in a hospital or institution Lawrencetown
3. PRINT NAME OF DECEASED Theriault, John Wayne
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 1 4, 1962
10. AGE in Years8 Months5 Days5 | hrs or mins
11. Trade or profession Student at Lawrencetown
12. Kind of industry
13. Date last worked June 9, 1970 14. Total years 2
15. If married name of spouse
16. NAME of Father Joseph A. A. Theriault
17. BIRTHPLACE New Brunswick
18. NAME of Mother Edna Casey
19. BIRTHPLACE Quebec
20. Signature of Informant J. A. A. Theriault
address Lawrencetown, Halifax Co
Relationship to deceased Father
21. Place of burial Mt. Hermon, Dart.
Date of burial June 11, 1970
22. Undertaker F. A. McDonald Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 9, 1970
CAUSE OF DEATH
(a) Asphyxiation
(b) Drowning in small lake
(c)
other Accident
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