Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Josef Stanislaw Rutkowski death at Clementsvale, Annapolis County on February 6, 1970
Male Death Registration: Year: 1970 number: 1572
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001572
1. PLACE OF DEATH County of Annapolis If in City or Town Clementsvale
If death occured in a hospital or institution Main Highway Clementsvale
3. PRINT NAME OF DECEASED Rutkowski, Josef Stanislaw
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Polish German
7. Single, Married
single
8. BIRTHPLACE Germany
9. DATE OF BIRTH 3 19, 1950
10. AGE in Years19 Months10 Days18 | hrs or mins
11. Trade or profession Unemployed
12. Kind of industry Labourer
13. Date last worked 1969 14. Total years
15. If married name of spouse
16. NAME of Father Stanley Rutkowski
17. BIRTHPLACE Poland
18. NAME of Mother Gertrud Butenschon
19. BIRTHPLACE Germany
20. Signature of Informant Gertrud Rutkowski
address Morganville
Relationship to deceased Mother
21. Place of burial Digby
Date of burial Feb. 9th, 1970
22. Undertaker Reginald Jayne, Digby
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 6, 1970
CAUSE OF DEATH
(a) Brain injury
(b) Fractured skull
(c)
other
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