Male Death Registration: Year: 1970 number: 4848
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004848
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Regional Hospital
3. PRINT NAME OF DECEASED Surette, Henri Eloi
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE Middle West Pubnico
9. DATE OF BIRTH 2 24, 1885
10. AGE in Years85 Months5 Days12 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Ann Marguerite d'Entremont
16. NAME of Father Nicholas Surette
17. BIRTHPLACE Middle West Pubnico
18. NAME of Mother Francoise Bourque
19. BIRTHPLACE Belleville
20. Signature of Informant Angeline F. d'Entremont
address West Pubnico
Relationship to deceased Daughter
21. Place of burial Middle West Pubnico
Date of burial August 8, 1970
22. Undertaker West Pubnico Funeral Service
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 5, 1970
CAUSE OF DEATH
(a) Myocardial infarction
(b) L. vent. failure
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=490157
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