Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Percy Leroy Lake death at Cheverie, Hants County on March 17, 1970
Male Death Registration: Year: 1970 number: 2374
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002374
1. PLACE OF DEATH County of Hants If in City or Town Cheverie
If death occured in a hospital or institution Cheverie Hants Co
3. PRINT NAME OF DECEASED Lake, Percy Leroy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Brookville, Hants County
9. DATE OF BIRTH 3 22, 1889
10. AGE in Years80 Months11 Days25 | hrs or mins
11. Trade or profession
12. Kind of industry Retired
13. Date last worked 14. Total years
15. If married name of spouse Lucy Laffin
16. NAME of Father Frederick Lake
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Winnifred Zwicker
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Roy Lake
address Cheverie Hants Co
Relationship to deceased Wife
21. Place of burial Moosebrook Hants Co.
Date of burial March 21 1970
22. Undertaker Lindsay Windsor
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 17, 1970
CAUSE OF DEATH
(a) Coronary Occlusion
(b) Arterosclerosis
(c)
other
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