Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Nickerson death at Yarmouth, Yarmouth County on September 24, 1971
Male Death Registration: Year: 1971 number: 6147
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006147
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,
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Yarmouth
9. DATE OF BIRTH 9 24, 1971
10. AGE in Years Months Days | 2 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 Harold Nickerson
17. BIRTHPLACE Shelbourne, Nova Scotia
18. NAME of Mother Beryl Porber
19. BIRTHPLACE Shelbourne Co, Nova Scotia
20. Signature of Informant Beryl Nickerson
address Box 4, Barrington, Shelburne Co, N.S
Relationship to deceased Mother
21. Place of burial Village Dale, Shelburne Co.
Date of burial October 1, 1971
22. Undertaker Sweeny's Funeral Home, Yarmouth Yarmouth
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 24, 1971
CAUSE OF DEATH
(a) Multiple Congenital Anomalies
(b)
(c)
other
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