Nova Scotia Archives

Nova Scotia Births, Marriages, and Deaths

John Schima death at Sydney, Cape Breton County on September 14, 1971

Male Death Registration: Year: 1971 number: 5598

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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH

02 - 005598

1. PLACE OF DEATH   County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution City Hospital

3. PRINT NAME OF DECEASED Schima, John

4. Sex

Male

5. Citizenship

Canadian

6. Racial Origin

German

7. Single, Married

married

8. BIRTHPLACE Germany

9. DATE OF BIRTH 4  1, 1906

10. AGE in  Years65  Months5  Days13 | hrs or mins

11. Trade or profession Retired Miner

12. Kind of industry Mining

13. Date last worked 1960       14. Total years 40 years

15. If married name of spouse Doris Chipman

16. NAME of Father John Schima

17. BIRTHPLACE NS

18. NAME of Mother Christena Gausthouse

19. BIRTHPLACE Germany

20. Signature of Informant Doris Schima

      address 160 Queen Street, North Sydney, Cape Breton Co., NS

      Relationship to deceased Wife

21. Place of burial North Sydney, Cape Breton Co., NS

      Date of burial 18 September 1971

22. Undertaker Fillmore & Whitman Funeral Home, North Sydney, Cape Breton Co., NS

MEDICAL CERTIFICATE OF DEATH

23. DATE OF DEATH September 14, 1971

CAUSE OF DEATH

(a) Coronary Thrombosis

(b)

(c)

other

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