Nova Scotia Archives

Nova Scotia Births, Marriages, and Deaths

Victor Koziel death at Glace Bay, Cape Breton County on September 26, 1970

Male Death Registration: Year: 1970 number: 6809

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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH

02 - 006809

1. PLACE OF DEATH   County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution St. Joseph's Hospital

3. PRINT NAME OF DECEASED Koziel, Victor

4. Sex

Male

5. Citizenship

Canadian

6. Racial Origin

Polish

7. Single, Married

married

8. BIRTHPLACE Poland

9. DATE OF BIRTH 7  18, 1903

10. AGE in  Years67  Months2  Days8 | hrs or mins

11. Trade or profession Confectionary store

12. Kind of industry Self-employed

13. Date last worked 1958       14. Total years 20

15. If married name of spouse Cecilia Tavgrub

16. NAME of Father Albert Koziel

17. BIRTHPLACE Poland

18. NAME of Mother Maria 

19. BIRTHPLACE Poland

20. Signature of Informant Victor Koziel Jr

      address 123 Wallace Road, Glace Bay

      Relationship to deceased Son

21. Place of burial St. John's Cemetery, Glace Bay

      Date of burial Sept 30, 1970

22. Undertaker Curry's Funeral Home, Glace Bay

MEDICAL CERTIFICATE OF DEATH

23. DATE OF DEATH September 26, 1970

CAUSE OF DEATH

(a) Pulmonary emphysema

(b)

(c)

other

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