Male Death Registration: Year: 1970 number: 4894
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004894
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Basinview Home
3. PRINT NAME OF DECEASED Johnson, Clifford
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
African
7. Single, Married
single
8. BIRTHPLACE Halifax County
9. DATE OF BIRTH 3 12, 1896
10. AGE in Years74 Months5 Days5 | hrs or mins
11. Trade or profession Laborer
12. Kind of industry Retired
13. Date last worked 1966 14. Total years 50
15. If married name of spouse
16. NAME of Father Scott Ellis Johnson
17. BIRTHPLACE Hammonds Plains
18. NAME of Mother Annie Elizabeth Kellam
19. BIRTHPLACE Halifax
20. Signature of Informant Joseph W. Johnson
address 2787 Connolly St. Halifax
Relationship to deceased Brother
21. Place of burial Camp Hill Cemetery Halifax
Date of burial Aug 19, 1970
22. Undertaker Cruikshank Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 17, 1970
CAUSE OF DEATH
(a) Senility
(b) generalized arteriosclerosis
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=490203
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