Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clarence Ellsworth Haystead death at Kentville, Kings County on March 15, 1970
Male Death Registration: Year: 1970 number: 2295
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002295
1. PLACE OF DEATH County of Kings If in City or Town Kentville
If death occured in a hospital or institution Nova Scotia Sanatorium.
3. PRINT NAME OF DECEASED Haystead, Clarence Ellsworth
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 2 7, 1904
10. AGE in Years66 Months1 Days8 | hrs or mins
11. Trade or profession DAR- Employee
12. Kind of industry Retired.
13. Date last worked 1962 14. Total years 43
15. If married name of spouse Amy Mildred
16. NAME of Father Frederick Haystead
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Lena Beech
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Amy Haystead
address 1977 Main St., Kentville
Relationship to deceased Wife
21. Place of burial Elm Grove, Kentville
Date of burial March 1970
22. Undertaker
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 15, 1970
CAUSE OF DEATH
(a)
(b)
(c)
other
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