Male Death Registration: Year: 1970 number: 5180
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005180
1. PLACE OF DEATH County of Yarmouth If in City or Town Wedgeport
3. PRINT NAME OF DECEASED Surette, James Walter
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 7 29, 1949
10. AGE in Years21 Months Days25 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry Fishing
13. Date last worked 14. Total years
15. If married name of spouse Florence M. Surette
16. NAME of Father Wallace J. Surette
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Pauline M. Cornu
19. BIRTHPLACE New Brunswick
20. Signature of Informant Mrs. Leonard Doucet
address Lr. Wedgeport
Relationship to deceased Sister
21. Place of burial Wedgeport
Date of burial August 26, 1970
22. Undertaker Sweeney's Funeral Home, Yarmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 23, 1970
CAUSE OF DEATH
(a) Fractured skull
(b)
(c)
other Fracture left femur and left tibia
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=490488
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