Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Ludwig Chalupa death at Sydney, Cape Breton County on June 11, 1971
Male Death Registration: Year: 1971 number: 3885
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003885
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution Sydney City Hospital
3. PRINT NAME OF DECEASED Chalupa, Ludwig
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Polish
7. Single, Married
married
8. BIRTHPLACE Poland
9. DATE OF BIRTH 5 22, 1904
10. AGE in Years67 Months Days20 | hrs or mins
11. Trade or profession Stealworker
12. Kind of industry Dosco
13. Date last worked 2 yrs ago 14. Total years
15. If married name of spouse Mary Chmiel Chalupa
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Mary Chalupa
address 113 Ferris St., Sydney, NS
Relationship to deceased Widow
21. Place of burial New Calvary Cemetery, Sydney, NS
Date of burial June 14, 1971
22. Undertaker R.H. Fillmore Funeral Home Ltd, Sydney, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 11, 1971
CAUSE OF DEATH
(a) Carcinomatosis
(b) Carcinoma of Pancreas
(c)
other
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