John Henry Curtis Death Certificate

R.G.4 NEW ZEALAND

Certified Copy of Entry in the Register Book of Deaths Number 27941

Place of Registration: Hastings

1. Name and Surname. JOHN CURTIS

2. Profession or Occupation. Labourer not a pensioner

3. Usual place of residence. –

4. Sex. Age. Date of Birth. M 65

5. When died. 11th September 1908

6. Where died. Hastings Hawkes Bay

7. Where born. Cornwall, England

8. How long in New Zealand. 30 years

9. Name and Surname of Father. Thomas Curtis

10. Name and Surname of Mother. Annie Curtis

11. Maiden Surname of Mother. Nicholls

12. Profession or Occupation of Father. Miner

13 Where married. (A) Cornwall, England  (B) Cornwall, England

14. At what Age married. (A) 23 (B) 33

15, To whom married. (A) Johanna Nutwill (B) Elizabeth Ellery

16. Age of Widow, if living. —

17. If Issue1iving, state Ages of each sex. M. 8, 15, 16, 26, 30. F. 6, 11, 13, 19, 20, 22, 23, 25

18. When buried. 13 September 1908

19. Where buried. Hastings Hawkes Bay

20. Causes of Death and Intervals between Onset and Death. Heart Disease. Syncope

21. Medical Attendant by whom certified. E.A. Copland

22. When he last saw Deceased (i.e., before death). 11 September 1908

I hereby certify that the above is a true copy of the above particulars included in an entry of death in the Register Book kept in my office.

Dated at Hastings the 18th day of December 1987

[signed by] Deputy Registrar

CAUTION – Any person who (1) falsifies any of the particulars on this certificate, or (2) uses it as true, knowing it to be false, is liable to prosecution under the Crimes Act 1961.