Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clarence Lars Haugen death at Halifax, Halifax County on August 9, 1970
Male Death Registration: Year: 1970 number: 4871
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004871
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution 1867 Barrington St.
3. PRINT NAME OF DECEASED Haugen, Clarence Lars
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Norwegian
7. Single, Married
widowed
8. BIRTHPLACE Halifax
9. DATE OF BIRTH 4 9, 1907
10. AGE in Years63 Months4 Days0 | hrs or mins
11. Trade or profession Printer
12. Kind of industry
13. Date last worked 1960 14. Total years 35
15. If married name of spouse
16. NAME of Father Lewis Haugen
17. BIRTHPLACE Norway
18. NAME of Mother Blanche Owen
19. BIRTHPLACE Dartmouth
20. Signature of Informant Mrs. John Almolky
address 5665 Cogswell St. Halifax
Relationship to deceased sister
21. Place of burial Fairview Cemetery Halifax
Date of burial Aug 11, 1970
22. Undertaker Cruikshank Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 9, 1970
CAUSE OF DEATH
(a) Coronary occlusion
(b) artereosclerosis
(c)
other
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