Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles Lavisky death at North Sydney, Cape Breton County on October 1, 1971
Male Death Registration: Year: 1971 number: 5743
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005743
1. PLACE OF DEATH County of Cape Breton If in City or Town North Sydney
If death occured in a hospital or institution St. Elizabeth Hospital
3. PRINT NAME OF DECEASED Lavisky, Charles
4. Sex
Male
5. Citizenship
American
6. Racial Origin
Lithuanian
7. Single, Married
married
8. BIRTHPLACE U.S.A.
9. DATE OF BIRTH 3 3, 1912
10. AGE in Years59 Months6 Days29 | hrs or mins
11. Trade or profession Unemployed
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Anna Lavisky
16. NAME of Father Severn Lasowicki
17. BIRTHPLACE Lithuania
18. NAME of Mother Stella Muleronka
19. BIRTHPLACE Lithuania
20. Signature of Informant Anna L. Lavisky
address 9848 Quandt St., Allen Park, Mich.
Relationship to deceased Wife
21. Place of burial Detroit, Michigan
Date of burial October 4, 1971
22. Undertaker W.J. Dooley Funeral Svc. Ltd., North Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 1, 1971
CAUSE OF DEATH
(a) Myocardial infarction
(b)
(c)
other
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