Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Edward Jeffery Jefferson death at Annapolis Royal, Annapolis County on September 16, 1971
Male Death Registration: Year: 1971 number: 5577
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005577
1. PLACE OF DEATH County of Annapolis If in City or Town Annapolis Royal
If death occured in a hospital or institution Stewarts Nursing Home
3. PRINT NAME OF DECEASED Jefferson, Edward Jeffery
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
separated
8. BIRTHPLACE Round Hill, Anna. County
9. DATE OF BIRTH 3 24, 1882
10. AGE in Years89 Months5 Days23 | hrs or mins
11. Trade or profession Labourer
12. Kind of industry
13. Date last worked 1962 14. Total years 60 yrs
15. If married name of spouse
16. NAME of Father William Jefferson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Isabel Clarke
19. BIRTHPLACE Nova Scotia
20. Signature of Informant P. G. Jefferson
address 84 Runnymede Rd, Kingston, Ont.
Relationship to deceased Grandson
21. Place of burial Round Hill Cemetery, NS
Date of burial Sept 18, 1971
22. Undertaker Charles Dargie & nSon Ltd., Annapolis Royal, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 16, 1971
CAUSE OF DEATH
(a) Uraemia
(b) Cardio Arythmia
(c)
other
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