Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Daisy Belle Clarke death at Springhill, Cumberland County on January 5, 1970
Female Death Registration: Year: 1970 number: 1151
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001151
1. PLACE OF DEATH County of Cumberland If in City or Town Springhill
If death occured in a hospital or institution MacAloney's Nursing Home
3. PRINT NAME OF DECEASED Clarke, Daisy Belle
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 11 23, 1895
10. AGE in Years74 Months1 Days13 | hrs or mins
11. Trade or profession housewife
12. Kind of industry
13. Date last worked Jan 5, 1970 14. Total years 54 years
15. If married name of spouse Harry Charles Clarke
16. NAME of Father Ora Moore
17. BIRTHPLACE Nova Scotia
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant R. Clarke
address West Amherst
Relationship to deceased son
21. Place of burial Springhill
Date of burial January 8th, 1970
22. Undertaker A.H. Brown Funeral Service Ltd., Springhill
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 5, 1970
CAUSE OF DEATH
(a) pneumonia
(b)
(c)
other
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