Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Everett Mariner Nickerson death at Yarmouth, Yarmouth County on August 21, 1971
Male Death Registration: Year: 1971 number: 5197
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005197
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 Nickerson, Everett Mariner
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 1, 1914
10. AGE in Years56 Months10 Days20 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked July 1971 14. Total years 37 yrs
15. If married name of spouse
16. NAME of Father Harris Nickerson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Hilda Nickerson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Hilda Nickerson
address Clarks Harbor, NS
Relationship to deceased Mother
21. Place of burial Clarks Harbor, NS
Date of burial August 24, 1971
22. Undertaker Kenney Funeral Service, Barrington, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 21, 1971
CAUSE OF DEATH
(a) Small Bowel Obstruction
(b) Fibrous Adhesion
(c)
other
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