Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Jensen death at Halifax, Halifax County on March 11, 1971
Male Death Registration: Year: 1971 number: 2117
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002117
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution V G Hospital
3. PRINT NAME OF DECEASED Jensen, John
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Newfoundland
7. Single, Married
single
8. BIRTHPLACE Harbour Breton, Newfoundland
9. DATE OF BIRTH 4 3, 1904
10. AGE in Years66 Months11 Days8 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father John Jansen
17. BIRTHPLACE Newfoundland
18. NAME of Mother Catherine Gunderson
19. BIRTHPLACE Newfoundland
20. Signature of Informant Mrs Lora Walters
address 18 Sunnydale Ave, Dartmouth
Relationship to deceased Sister
21. Place of burial Dartmouth Memorial Gardens
Date of burial March 13, 1971
22. Undertaker A L Mattatall F.H., 217 Portland St. Dartmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 11, 1971
CAUSE OF DEATH
(a) Metastases
(b) Carcinoma of under stomach
(c)
other
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