Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Timothy Jan Crouse death at Bakers Settlement, Lunenburg County on May 17, 1970
Male Death Registration: Year: 1970 number: 3397
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003397
1. PLACE OF DEATH County of Lunenburg If in City or Town Bakers Settlement
3. PRINT NAME OF DECEASED Crouse, Timothy Jan
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
single
8. BIRTHPLACE Bridgewater
9. DATE OF BIRTH 9 9, 1966
10. AGE in Years3 Months8 Days8 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Donald G Crouse
17. BIRTHPLACE East Clifford
18. NAME of Mother Margaret Alena Oickle
19. BIRTHPLACE Maitland
20. Signature of Informant Mrs Glenice Boliver
address Bridgewater, RR#5
Relationship to deceased Aunt
21. Place of burial Baker Settlement, Lun. Co.
Date of burial May 20, 1970
22. Undertaker Stan Wamback, Bridgewater
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 17, 1970
CAUSE OF DEATH
(a) Fracture of base of skull with cerebral laceration and contusion
(b) fracture and fracture dislocation of cervical vertrebral column
(c)
other pedestrian traffic accident
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