Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Patrick Jules Nickerson death at Yarmouth, Yarmouth County on October 1, 1971
Male Death Registration: Year: 1971 number: 5955
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005955
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Hospital
3. PRINT NAME OF DECEASED Nickerson, Patrick Jules
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Yarmouth
9. DATE OF BIRTH 9 30, 1971
10. AGE in Years Months Days1 | 12 hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Jules Nickerson
17. BIRTHPLACE Yarmouth
18. NAME of Mother Hazel Hubbard
19. BIRTHPLACE Yarmouth
20. Signature of Informant Mrs. Willard J. Hubbard
address 43 Brunswick St., Yarmouth
Relationship to deceased Grand-Mother
21. Place of burial Yarmouth
Date of burial October 4, 1971
22. Undertaker Sweeny's Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 1, 1971
CAUSE OF DEATH
(a) Neonatal Pneumonia
(b) Premature
(c)
other
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