Male Death Registration: Year: 1970 number: 5958
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005958
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Children's Hospital
3. PRINT NAME OF DECEASED Jubber,
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Prince Edward Island
9. DATE OF BIRTH 8 17, 70
10. AGE in Years Months Days1 | 24 hrs or 40 mins
11. Trade or profession
12. Kind of industry Infant.
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Charles Jubber
17. BIRTHPLACE Prince Edward Island
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Records
address Childrens Hospital
Relationship to deceased Hospital
21. Place of burial Charlettown Prince Edward Island.
Date of burial Aug 20 1970
22. Undertaker R.D. Lindsay Halifax
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 18, 1970
CAUSE OF DEATH
(a) Atelectasis (collapsed lung)
(b) Prematurity
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=491266
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