Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Lewis Smith death at Clarks Harbour, Shelburne County on January 11, 1970
Male Death Registration: Year: 1970 number: 1184
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001184
1. PLACE OF DEATH County of Shelburne If in City or Town Clarks Harbour
3. PRINT NAME OF DECEASED Smith, Lewis
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 3 23, 1893
10. AGE in Years76 Months9 Days19 | hrs or mins
11. Trade or profession fisherman
12. Kind of industry fishing
13. Date last worked 1955 14. Total years 46
15. If married name of spouse Goldie Smith
16. NAME of Father Howard Smith
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Delilah Stoddard
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Gloria Ross
address 1335 Birmingham St., Halifax
Relationship to deceased daughter
21. Place of burial Lower Clarks Harbour
Date of burial January 14, 1970
22. Undertaker Kenney Funeral Service
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 11, 1970
CAUSE OF DEATH
(a) cerebral thrombosis
(b) arteriosclerosis
(c)
other
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