Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles William Nickerson death at Yarmouth, Yarmouth County on December 26, 1971
Male Death Registration: Year: 1971 number: 7611
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007611
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Regional Hospital
3. PRINT NAME OF DECEASED Nickerson, Charles William
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Woods Harbour
9. DATE OF BIRTH 5 4, 1892
10. AGE in Years79 Months7 Days22 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked 1952 14. Total years 42
15. If married name of spouse Julia Brown
16. NAME of Father Seth Nickerson
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Annie O'Connll
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Julia Nickerson
address Central Woods Harbour, Shelburne Co.
Relationship to deceased Wife
21. Place of burial Woods Harbour, Nova Scotia
Date of burial 29 December 1971
22. Undertaker Kenney's Funeral Home, Baarrington
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 26, 1971
CAUSE OF DEATH
(a) Ventricular Fibrillation
(b) Arteriosclerosis
(c)
other
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Note: Maiden name of wife of deceased obtained from marriage certificate