Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Robin Moulaison death at Morris Island, Yarmouth County on December 10, 1971
Male Death Registration: Year: 1971 number: 7248
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007248
1. PLACE OF DEATH County of Yarmouth If in City or Town Morris Island
If death occured in a hospital or institution Coronary occlusion
3. PRINT NAME OF DECEASED Moulaison, John Robin
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Surette's Island, Yar. County
9. DATE OF BIRTH 7 26, 1876
10. AGE in Years95 Months4 Days14 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Fisherman
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Beatrice Jane Surette
address RR#2, Box 918, Lusket
Relationship to deceased Friend
21. Place of burial Surette's Island, Yar.
Date of burial December 13, 1971
22. Undertaker Sweeny's Funeral Home, Yar.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 10, 1971
CAUSE OF DEATH
(a) Arteriosclerosis
(b)
(c)
other
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