| 1. PLACE OF DEATH |
County or District of York Township of East York
If in City, Town or Village
|
| 2. LENGTH OF STAY |
(a) In City, Town or Township where death occurred 9 yrs
(b) In Province 9 yrs (c) In Canada (if immigrant) 9 yrs |
| 3. NAME OF DECEASED | Gibson Ward |
| RESIDENCE |
No 250
Street Glebemount Ave City, Town, Village or Township Totonto Province Ont |
| 4. Sex | M |
| 5. Nationality | Eng |
| 6. Racial Origin | White |
| 7. Single, Married, Widowed or Divorced | M |
| 8. BIRTHPLACE | England |
| 9. DATE OF BIRTH | July 29/1880 |
| 10. Age | Years 57 Months 10 Days 20 |
| 11. Trade, profession or kind of work as spinner, teamaster, office clerk etc. | Engineer |
| 12. Kind of industry or business, as cotton mill, lumbering, bank, etc | Mechanical |
| 13. Date deceased last worked at this occupation | 1931 |
| 14. Total yrs. spent in this occupation | 40 yrs |
| 15. If married give the name of wife or husband of deceased | Mrs Jessie Gibson |
| 16. Father's Name | John Gibson |
| 17. Father's Birthplace | England |
| 18. Mother's Maiden Name | not known |
| 19. Mother's Birthplace | England |
| 20. Person giving information |
sign here
Mrs Jessie Gibson
Address 250 Glebemount Ave Toronto Relationship to deceased Wife |
| 21. Place of Burial, Cremation or Removal | Norway? Cemetery, Toronto |
| Date of Burial or Removal | June 21/38 |
| 22. UNDERTAKER |
??? ??? ??
111 Dinforth? ?? Toronto |
| 23. DATE OF DEATH | June 18th. 1938 |
| 24. I HEREBY CERTIFY |
that I attended deceased from Summer 1936 to June 18 1938
and last saw him alive on June 18th. 1938 |
| Immediate Cause of Death | Cancer of Stomach, Liver, Lungs - ??? ??? |
| Morbid conditions | ?? Rheumatic ??? due to ?? ?? Insufficiency |
| Other morbid conditions | Bronchial? Asthma |
| 25. If a woman, was the death associated with pregnany? | |
| 26. Was there a surgical operation? | No |
| Was there aan autopsy? | No |
| 27.If death was due to external ??, (violence) fill in also the following | |
| 26. Was there a surgical operation? | No |
|
Signed by J.P. ???
Address 3 Donegal Dr Date June 18 1938 |
|
| 28. Division Registrar's Record Number | 147 |
| 29 Filed | June 22nd |
Source: Archives of Ontario; Series: MS935; Reel: 615
Source: Ancestry.com. Ontario, Canada, Deaths, 1869-1938 and Deaths Overseas, 1939-1947