Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Jack William Taylor death at Middleton, Annapolis County on May 5, 1970
Male Death Registration: Year: 1970 number: 3817
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003817
1. PLACE OF DEATH County of Annapolis If in City or Town Middleton
If death occured in a hospital or institution S M Hospital
3. PRINT NAME OF DECEASED Taylor, Jack William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 7 3, 1953
10. AGE in Years16 Months10 Days2 | hrs or mins
11. Trade or profession Labourer
12. Kind of industry Dept of Highways
13. Date last worked May 4 - 70 14. Total years 3 mos
15. If married name of spouse
16. NAME of Father Ralph Taylor
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Evelyn Melanson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs Leonard Melanson
address Middleton RR#3, Anna Co
Relationship to deceased Grandmother
21. Place of burial Lawrencetown, Anna Co
Date of burial May 8 -70
22. Undertaker Warren T Roop Ltd, Middleton
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 5, 1970
CAUSE OF DEATH
(a) Internal injuries & fractured skull
(b)
(c)
other Accident - thrown from car
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