Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clarence Jerome Andrews death at Antigonish, Antigonish County on August 16, 1970
Male Death Registration: Year: 1970 number: 5052
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005052
1. PLACE OF DEATH County of Antigonish If in City or Town Antigonish
If death occured in a hospital or institution St. Martha's Hospital
3. PRINT NAME OF DECEASED Andrews, Clarence Jerome
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Guysborough
9. DATE OF BIRTH 10 28, 1946
10. AGE in Years33 Months7 Days19 | hrs or mins
11. Trade or profession Labourer
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Charles Andrews
17. BIRTHPLACE Manchester
18. NAME of Mother Violet Pelly
19. BIRTHPLACE Guysborough
20. Signature of Informant Mrs. Violet Andrews
address Guysborough
Relationship to deceased Mother
21. Place of burial Guysborough
Date of burial August 19, 1970
22. Undertaker Nathan Rhynold, Philips Harbour
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 16, 1970
CAUSE OF DEATH
(a) Laceration of Brain
(b) Fractures of Skull
(c)
other Multiple skeletal fractures, 2 car collision
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