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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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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