Male Death Registration: Year: 1970 number: 3109
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003109
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution At home
3. PRINT NAME OF DECEASED Crooks, Robert
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
married
8. BIRTHPLACE Uphill, Scotland
9. DATE OF BIRTH 12 21, 1895
10. AGE in Years74 Months4 Days | hrs or mins
11. Trade or profession Cape Breton Dairy Co-op
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Irene Reeves Crooks
16. NAME of Father James Crooks
17. BIRTHPLACE Scotland
18. NAME of Mother Annie Thompson
19. BIRTHPLACE Scotland
20. Signature of Informant Mrs. Robert Crooks
address 40 Richardson Ave., Sydney
Relationship to deceased Widow
21. Place of burial Hardwood Hill Cemetery, Sydney
Date of burial April 24, 1970
22. Undertaker R.H. Fillmore Funeral Home Ltd., Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH April 21, 1970
CAUSE OF DEATH
(a) Cerebrovascular Accident
(b) Carcinoma of lung with metastases
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=488419
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