Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Henri Rene Gautier death at Halifax, Halifax County on September 1, 1970
Male Death Registration: Year: 1970 number: 5327
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005327
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary
3. PRINT NAME OF DECEASED Gautier, Henri Rene
4. Sex
Male
5. Citizenship
French
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE St. Pierre and Miquelon
9. DATE OF BIRTH 10 26, 1910
10. AGE in Years59 Months10 Days6 | hrs or mins
11. Trade or profession General Merchant
12. Kind of industry self employed
13. Date last worked August 1, 1970 14. Total years 27
15. If married name of spouse Jeanne Lebailly
16. NAME of Father Joseph Gautier
17. BIRTHPLACE St. Pierre, Miquelon
18. NAME of Mother Carre Vectorio
19. BIRTHPLACE St. Pierre, Miquelon
20. Signature of Informant Mrs. Henri R. Gautier, FMC
address St. Pierre, Miquelon
Relationship to deceased Wife
21. Place of burial St. Pierre, Miquelon
Date of burial September 3, 1970
22. Undertaker Halifax Funeral Home, LTD
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 1, 1970
CAUSE OF DEATH
(a) Septicemic shock
(b) Bronchopneumonia
(c)
other Arteriosclerotic Heart Disease
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