Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Lawrence William Shupe death at Halifax, Halifax County on December 12, 1970
Male Death Registration: Year: 1970 number: 7165
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007165
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Camp Hill Hospital
3. PRINT NAME OF DECEASED Shupe, Lawrence William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 7 10, 1910
10. AGE in Years60 Months5 Days2 | hrs or mins
11. Trade or profession Canteen
12. Kind of industry Owner
13. Date last worked 14. Total years 15
15. If married name of spouse Jessie (Verge)
16. NAME of Father Joseph Shupe
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Annie Hiltz
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Jessie Shupe
address R.R.#1 Waverly, NS
Relationship to deceased Wife
21. Place of burial St. John's Cemetery, Halifax
Date of burial Dec 15 1970
22. Undertaker Lindsay's, Halifax
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 12, 1970
CAUSE OF DEATH
(a) Duodenal ulcer and hemorrhage
(b) Bronchial Asthma
(c)
other Generalized Arteriosclerosis
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