Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Agnes Louise McClearn death at Liverpool, Queens County on August 15, 1970
Female Death Registration: Year: 1970 number: 4980
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004980
1. PLACE OF DEATH County of Queens If in City or Town Liverpool
If death occured in a hospital or institution Queens General Hospital
3. PRINT NAME OF DECEASED McClearn, Agnes Louise
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
single
8. BIRTHPLACE Liverpool
9. DATE OF BIRTH 5 19, 1883
10. AGE in Years87 Months2 Days29 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Nurse
13. Date last worked 1958 14. Total years 50
15. If married name of spouse
16. NAME of Father John D McClearn
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Annie M Spurr
19. BIRTHPLACE Nova Scotia
20. Signature of Informant R McClearn
address Liverpool
Relationship to deceased Nephew
21. Place of burial Liverpool
Date of burial 17 August 1970
22. Undertaker Chandler's Funeral Service
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 15, 1970
CAUSE OF DEATH
(a)
(b)
(c)
other
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