Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Claude Douglas Smith death at Sandy Point, Shelburne County on July 14, 1970
Male Death Registration: Year: 1970 number: 4489
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004489
1. PLACE OF DEATH County of Shelburne If in City or Town Sandy Point
If death occured in a hospital or institution Roseway Hospital, Sandy Point
3. PRINT NAME OF DECEASED Smith, Claude Douglas
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
divorced
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 7 7, 1900
10. AGE in Years70 Months0 Days7 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry
13. Date last worked 1962 14. Total years 44
15. If married name of spouse
16. NAME of Father Charles Smith
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Augusta Williams
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Gerald Smith
address North East Point
Relationship to deceased Son
21. Place of burial Centerville, Sherburne County
Date of burial 17 July 1970
22. Undertaker Kenney Funeral Service, per T. A. K. Barrington, Shelburne Co
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 14, 1970
CAUSE OF DEATH
(a) Posterior Myocardial Infarction
(b) Coronary Artery Disease
(c)
other
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