Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Clarke death at Pictou, Pictou County on August 19, 1970
Male Death Registration: Year: 1970 number: 5161
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005161
1. PLACE OF DEATH County of Pictou If in City or Town Pictou
If death occured in a hospital or institution Sutherland Harris Memorial Hospital
3. PRINT NAME OF DECEASED Clarke, John
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Quebec
9. DATE OF BIRTH 7 2, 1883
10. AGE in Years87 Months1 Days17 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Boat Builder
13. Date last worked 1960 14. Total years Life
15. If married name of spouse Grace Rankin
16. NAME of Father Hugh Clarke
17. BIRTHPLACE Quebec
18. NAME of Mother Elizabeth A. Clarke
19. BIRTHPLACE Quebec
20. Signature of Informant Mrs. Bert Cheverie
address Pictou
Relationship to deceased Daughter
21. Place of burial Scotch Hill
Date of burial August 21, 1970
22. Undertaker MacKenzie Funeral Service, Scotsburn
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 19, 1970
CAUSE OF DEATH
(a) Pneumonia
(b)
(c)
other
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