Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Edward Michael Kokocki death at Halifax, Halifax County on May 28, 1971
Male Death Registration: Year: 1971 number: 3640
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003640
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Victoria General Hospital
3. PRINT NAME OF DECEASED Kokocki, Edward Michael
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Polish
7. Single, Married
married
8. BIRTHPLACE Sydney
9. DATE OF BIRTH 12 17, 1936
10. AGE in Years34 Months5 Days10 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Anne Steele
16. NAME of Father Michael Kokocki
17. BIRTHPLACE Poland
18. NAME of Mother Martina Trojan
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mr. Michael Kokocki
address 102 Bryant Street, Sydney, Nova Scotia
Relationship to deceased Brother
21. Place of burial Resurrection Cemetery, Sydney Forks, NS
Date of burial May 31, 1971
22. Undertaker T. W. Curry Ltd., Sydney, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 28, 1971
CAUSE OF DEATH
(a) Peritoneal Carcinomatosis
(b) Gastric Carcinoma
(c)
other
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