Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Andrew Coffin Jeffery death at Tusket, Yarmouth County on April 3, 1971
Male Death Registration: Year: 1971 number: 2824
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002824
1. PLACE OF DEATH County of Yarmouth If in City or Town Tusket
3. PRINT NAME OF DECEASED Jeffery, Andrew Coffin
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Pleasant Lake, Yar. Co
9. DATE OF BIRTH 6 15, 1883
10. AGE in Years87 Months9 Days19 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Blacksmith
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Randall Jeffery
17. BIRTHPLACE Pleasant Lake
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Andrew W Jeffery
address Tusket, Yarmouth Co. NS
Relationship to deceased son
21. Place of burial Tusket, Yar. Co. NS
Date of burial April 6, 1971
22. Undertaker Sweeny's Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 3, 1971
CAUSE OF DEATH
(a) Coronary Occlusion
(b) Arteriosclerosis
(c)
other (?) Thrombosis
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