Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Toby D. Nickerson death at Birchtown, Shelburne County on October 28, 1970
Male Death Registration: Year: 1970 number: 6496
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006496
1. PLACE OF DEATH County of Shelburne If in City or Town Birchtown
3. PRINT NAME OF DECEASED Nickerson, Toby D.
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 14, 1970
10. AGE in Years Months Days14 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Douglas Nickerson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Juanita Goulden
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Douglas Nickerson
address Birchtown
Relationship to deceased Father
21. Place of burial Birchtown
Date of burial October 30, 1970
22. Undertaker Huskilson's Funeral Home, Shelburne
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 28, 1970
CAUSE OF DEATH
(a) Acute Haemorrhagic Pneumonia
(b)
(c)
other
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