Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Jane Barbara Chisholm death at Eastern Passage, Halifax County on July 15, 1970
Female Death Registration: Year: 1970 number: 4569
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004569
1. PLACE OF DEATH County of Halifax If in City or Town Eastern Passage
If death occured in a hospital or institution Ocean View Manor
3. PRINT NAME OF DECEASED Chisholm, Jane Barbara
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Eastern Passage
9. DATE OF BIRTH 10 20, 1883
10. AGE in Years86 Months8 Days25 | hrs or mins
11. Trade or profession Retired House Duties
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Mr. Charles Chisholm
address Lake Echo, Halifax Co.
Relationship to deceased Son
21. Place of burial Dartmouth Memorial Gardens
Date of burial 18 July 1970
22. Undertaker Mattatall Funeral Services Ltd., Dartmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 15, 1970
CAUSE OF DEATH
(a) Myocardial Ischemia
(b) Arteriosclerosis
(c)
other
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