Female Death Registration: Year: 1970 number: 4085
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004085
1. PLACE OF DEATH County of Pictou If in City or Town New Glasgow
If death occured in a hospital or institution West Side Rest Home
3. PRINT NAME OF DECEASED Clark, Sarah Jane
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 23, 1883
10. AGE in Years86 Months7 Days3 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse William A Clark (deceased)
16. NAME of Father Alexander Sutherland
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Christine Campbell
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mr Robert Clark
address Beardmore, Ontario
Relationship to deceased Son
21. Place of burial Scotsburn
Date of burial May 28 1970
22. Undertaker MacKenzie, Scotsburn
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 26, 1970
CAUSE OF DEATH
(a) Coronary Artery Thrombosis
(b) Gangrene left Foot
(c) Generalized arterosclerosis
other Peripheral Vascular Arterial Disease
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=489394
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