Male Death Registration: Year: 1971 number: 3350
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003350
1. PLACE OF DEATH County of Queens If in City or Town Liverpool
If death occured in a hospital or institution Queens General Hosp
3. PRINT NAME OF DECEASED Chaisson, Joseph Jerry
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Miscou, New Brunswick, Canada
9. DATE OF BIRTH 11 24, 1904
10. AGE in Years66 Months5 Days16 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry Truck Driver
13. Date last worked 1969 14. Total years
15. If married name of spouse
16. NAME of Father Thomas Chaisson
17. BIRTHPLACE New Brunswick
18. NAME of Mother Helen LeBreton
19. BIRTHPLACE New Brunswick
20. Signature of Informant Mary Crouse
address Brooklyn, Queens Co., NS
Relationship to deceased Friend
21. Place of burial Liverpool, NS
Date of burial May 14, 1971
22. Undertaker Chandler's Funeral Service Ltd, Liverpool, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 12, 1971
CAUSE OF DEATH
(a) Carcinoma of stomach with Metastases to liver, lung and brain
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=495426
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