Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Johanna Maria Maessen death at Halifax, Halifax County on April 21, 1971
Female Death Registration: Year: 1971 number: 2974
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002974
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary
3. PRINT NAME OF DECEASED Maessen, Johanna Maria
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Indonesian
7. Single, Married
married
8. BIRTHPLACE Denpasar, Bali, Indonesia
9. DATE OF BIRTH 6 3, 1930
10. AGE in Years40 Months10 Days18 | hrs or mins
11. Trade or profession House duties
12. Kind of industry
13. Date last worked Nov/1970 14. Total years 19 yrs
15. If married name of spouse Everadus Maessen
16. NAME of Father Dr. F.W.T. Hunger
17. BIRTHPLACE Java, Indonesia
18. NAME of Mother Late Elizabeth Kapteyn
19. BIRTHPLACE Holland
20. Signature of Informant Everadus Maessen
address 6054 Shirley Street, Halifax
Relationship to deceased Husband
21. Place of burial Fairview Cemetery, Halifax
Date of burial April 23, 1971
22. Undertaker Cruikshank Funeral Home Limited
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 21, 1971
CAUSE OF DEATH
(a) Acute Myeloid Leukemia
(b)
(c)
other
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