Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Herbert Guy Cleversey death at Conquerall Bank, Lunenburg County on February 16, 1970
Male Death Registration: Year: 1970 number: 1792
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001792
1. PLACE OF DEATH County of Lunenburg If in City or Town Conquerall Bank
3. PRINT NAME OF DECEASED Cleversey, Herbert Guy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 3 1, 1912
10. AGE in Years57 Months11 Days15 | hrs or mins
11. Trade or profession at home.
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Single.
16. NAME of Father Mowre Cleversey
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Campbell
19. BIRTHPLACE Nova Scotia
20. Signature of Informant
address
Relationship to deceased BROTHER.
21. Place of burial
Date of burial
22. Undertaker
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 16, 1970
CAUSE OF DEATH
(a)
(b) Hypertension
(c)
other
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