Male Death Registration: Year: 1971 number: 4073
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004073
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Regional Hospital
3. PRINT NAME OF DECEASED Jacquard, Alfred
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Comeau Hill
9. DATE OF BIRTH 2 21, 1889
10. AGE in Years82 Months3 Days23 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked 1968 14. Total years
15. If married name of spouse Mary Eliza Jacquard
16. NAME of Father Robert Jacquard
17. BIRTHPLACE Comeau Hill, NS
18. NAME of Mother Elizabeth Saulnier
19. BIRTHPLACE Comeau Hill, NS
20. Signature of Informant Mrs. Mary Eliza Jacquard
address Comeau Hill, Yar. Co., NS
Relationship to deceased Wife
21. Place of burial Comeau Hill
Date of burial June 19, 1971
22. Undertaker H. M. Huskilsons Funeral Home, Albert Street, Yarmouth, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 16, 1971
CAUSE OF DEATH
(a) Cirrhosis of LIver
(b) Pancreatic attack enzymes
(c) Diabetes
other Arterial Hypertension
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=496148
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