Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Donald St. Clair Cleveland death at Indian Harbour, Halifax County on August 21, 1970
Male Death Registration: Year: 1970 number: 5115
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005115
1. PLACE OF DEATH County of Halifax If in City or Town Indian Harbour
3. PRINT NAME OF DECEASED Cleveland, Donald St. Clair
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Dutch
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 8 15, 1886
10. AGE in Years84 Months0 Days6 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Gertrude Hurshman
16. NAME of Father Elijah Cleveland
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Sophia Baker
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs Charles O'Neil
address Indian Harbour
Relationship to deceased Daughter
21. Place of burial St. Peters Cemetery, Hacketts Cove
Date of burial Aug 24, 1970
22. Undertaker J. Albert Walker
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 21, 1970
CAUSE OF DEATH
(a) Cerebro Vascular Accident
(b) Acute Gastritis
(c)
other
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