Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Mary Ann Jewells death at Glace Bay, Cape Breton County on June 20, 1971
Female Death Registration: Year: 1971 number: 5871
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005871
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution St. Joseph's Hospital
3. PRINT NAME OF DECEASED Jewells, Mary Ann
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Polish
7. Single, Married
married
8. BIRTHPLACE Donkin
9. DATE OF BIRTH 4 8, 1922
10. AGE in Years49 Months2 Days12 | hrs or mins
11. Trade or profession Houseduties (struck out), Housewife at home
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Ernest Jewells
16. NAME of Father Fred Kupusa
17. BIRTHPLACE Poland
18. NAME of Mother Florence
19. BIRTHPLACE Newfoundland
20. Signature of Informant Bill Kupusa
address Donkin, Cape Breton, NS
Relationship to deceased son
21. Place of burial St. Luke's, Donkin, NS
Date of burial June 23, 1971
22. Undertaker Curry's Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 20, 1971
CAUSE OF DEATH
(a) Hypertension
(b) Urinary Infection
(c)
other
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