Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles Edward Chisholm death at New Glasgow, Pictou County on May 20, 1970
Male Death Registration: Year: 1970 number: 4976
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004976
1. PLACE OF DEATH County of Pictou If in City or Town New Glasgow
If death occured in a hospital or institution Aberdeen Hospital
3. PRINT NAME OF DECEASED Chisholm, Charles Edward
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 5 17, 1970
10. AGE in Years Months Days3 | hrs or mins
11. Trade or profession
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 Elizabeth Ann Chisholm
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs Walter Brown
address Brook St., Trenton
Relationship to deceased Grandmother
21. Place of burial Hillside Cemetery, Trenton
Date of burial May 29, 1970
22. Undertaker Ross Funeral Homes
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 20, 1970
CAUSE OF DEATH
(a) Resp. Distress Syndrome
(b) Prematurity
(c)
other Ante-partum Haemorrage
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