Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Agnes Chaplin death at Tatamagouche, Colchester County on November 26, 1970
Female Death Registration: Year: 1970 number: 7084
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007084
1. PLACE OF DEATH County of Colchester If in City or Town Tatamagouche
If death occured in a hospital or institution Lillian Fraser Memorial Hosp
3. PRINT NAME OF DECEASED Chaplin, Agnes
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH , 1875
10. AGE in Years95 Months Days | hrs or mins
11. Trade or profession at home
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Harry Patton
address Greenfield, Col Co
Relationship to deceased None (Executor)
21. Place of burial Meaghers Grant, Halifax Co,
Date of burial November 29, 1970
22. Undertaker Mattatall Funeral Home, Truro
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 26, 1970
CAUSE OF DEATH
(a) Pneumonia
(b)
(c)
other
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