Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clarence Avondale Boutilier death at Sheet Harbour, Halifax County on September 7, 1970
Male Death Registration: Year: 1970 number: 5650
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005650
1. PLACE OF DEATH County of Halifax If in City or Town Sheet Harbour
If death occured in a hospital or institution Eastern Shore Memorial Hospital
3. PRINT NAME OF DECEASED Boutilier, Clarence Avondale
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 10, 1892
10. AGE in Years77 Months10 Days28 | hrs or mins
11. Trade or profession Fisherman
12. Kind of industry Fishing
13. Date last worked May 1970 14. Total years life
15. If married name of spouse Nora Boutilier
16. NAME of Father Mathew Boutilier
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Annie Power
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Clarence Boutilier
address Mushaboom
Relationship to deceased Wife
21. Place of burial Mushaboom, Halifax Co.
Date of burial Sept 9th 1970
22. Undertaker Parker Hamilton
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 7, 1970
CAUSE OF DEATH
(a) Uraemia
(b) Dehydration
(c) Cancer Pancreas
other
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