Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Nickerson death at Yarmouth, Yarmouth County on March 24, 1971
Male Death Registration: Year: 1971 number: 2582
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002582
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Regional Hospital
3. PRINT NAME OF DECEASED Nickerson, John
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 6 4, 1905
10. AGE in Years65 Months9 Days20 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry
13. Date last worked Dec 1970 14. Total years 46 yrs
15. If married name of spouse
16. NAME of Father Gordon Nickerson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Dewey Nickerson
address Clark's Harbour, NS
Relationship to deceased
21. Place of burial Clarks Harbour, NS
Date of burial March 28, 1971
22. Undertaker Kenney Funeral Service, Barrington, Shel. Co. NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 24, 1971
CAUSE OF DEATH
(a) Coronary Thrombosis
(b) Arteriosclerotic Heart Disease
(c)
other Gangrene
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