Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Jean Paul Rozaire Mantha death at at sea, Shelburne County on February 16, 1971
Male Death Registration: Year: 1971 number: 2456
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002456
1. PLACE OF DEATH County of Shelburne If in City or Town at sea
If death occured in a hospital or institution 20 miles at sea
3. PRINT NAME OF DECEASED Mantha, Jean Paul Rozaire
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE La Fleche, Quebec
9. DATE OF BIRTH 12 25, 1943
10. AGE in Years27 Months1 Days22 | hrs or mins
11. Trade or profession "Nomad"
12. Kind of industry
13. Date last worked Feb.15/71 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE Quebec
20. Signature of Informant Mrs. Ernest Mantha
address 1744 Walnut St., Apt. 1, LaFleche, Quebec
Relationship to deceased Mother
21. Place of burial Our Lade of Calvary, Yar.
Date of burial February 25, 1971
22. Undertaker H.M. Huskilson's Funeral Home, Albert Street, Box 284, Yarmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 16, 1971
CAUSE OF DEATH
(a) Pneumonitis Chained?
(b) Aspiration of Vomitus
(c) Intoxication
other
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