Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Kevin John Decoste death at East Havre Boucher, Antigonish County on October 7, 1970
Male Death Registration: Year: 1970 number: 6128
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006128
1. PLACE OF DEATH County of Antigonish If in City or Town East Havre Boucher
If death occured in a hospital or institution East Havre Boucher
3. PRINT NAME OF DECEASED Decoste, Kevin John
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 12 16, 1952
10. AGE in Years17 Months9 Days21 | hrs or mins
11. Trade or profession Labourer - Part Time
12. Kind of industry Pulp
13. Date last worked oCT 7, 1970 14. Total years 4 days
15. If married name of spouse
16. NAME of Father Daniel Decoste
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Josephine Casey
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Lloyd Decoste
address Frankville, Ant. Co.
Relationship to deceased Brother
21. Place of burial St. Paul's R.C. Cem. Havre Boucher
Date of burial Oct 10, 1970
22. Undertaker Curry Bros. Funeral Directors Ltd. Antigonish
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 7, 1970
CAUSE OF DEATH
(a) Laceration on Brain
(b) Fractured Skull
(c)
other
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