Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Samuel Nichols death at Yarmouth, Yarmouth County on October 31, 1971
Male Death Registration: Year: 1971 number: 6414
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006414
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
3. PRINT NAME OF DECEASED Nichols, Samuel
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Assyrian
7. Single, Married
married
8. BIRTHPLACE Lebanon
9. DATE OF BIRTH 2 24, 1892
10. AGE in Years79 Months8 Days7 | hrs or mins
11. Trade or profession Clothing
12. Kind of industry Merchant
13. Date last worked 14. Total years
15. If married name of spouse Emily Nichols
16. NAME of Father Isaac Shadroui Nichols
17. BIRTHPLACE Lebanon
18. NAME of Mother Adla Basil
19. BIRTHPLACE Lebanon
20. Signature of Informant Celia Shediac
address Yarmouth
Relationship to deceased Friend
21. Place of burial Yarmouth
Date of burial November 3, 1971
22. Undertaker Sweenys Funeral Home, Yarmouth, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 31, 1971
CAUSE OF DEATH
(a) Acute pulmonary oedema
(b) Arteriosclerosis Heart disease
(c)
other
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