Male Death Registration: Year: 1970 number: 5418
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005418
1. PLACE OF DEATH County of Kings If in City or Town Wolfville
If death occured in a hospital or institution Eastern Kings Memorial Hospital
3. PRINT NAME OF DECEASED Chipman, Reginald Henry
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Grand Pre
9. DATE OF BIRTH 4 23, 1888
10. AGE in Years82 Months4 Days7 | hrs or mins
11. Trade or profession Pharmacist
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Mary Edna Jenkins
16. NAME of Father Dr. Henry Chipman
17. BIRTHPLACE Chipman Corner
18. NAME of Mother Margaret Thomson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Mary E. Chipman
address Grand Pre
Relationship to deceased Wife
21. Place of burial St. John's Anglican Cemetery
Date of burial September 3, 1970 Thursday 3pm
22. Undertaker H.C. Lindsay Funeral Home, Wolfville
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 31, 1970
CAUSE OF DEATH
(a) Peritonitis
(b) perforated diverticulitis
(c) chronic diverticulitis colon
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=490726
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