Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Charles Robert Clements death at Glace Bay, Cape Breton County on October 6, 1970
Male Death Registration: Year: 1970 number: 6277
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006277
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution Victoria Haven Rest Home
3. PRINT NAME OF DECEASED Clements, Charles Robert
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 1 7, 1893
10. AGE in Years77 Months8 Days29 | hrs or mins
11. Trade or profession Retired Coal Miner
12. Kind of industry Dominion Coal Company
13. Date last worked 1945 14. Total years 20
15. If married name of spouse Lillie Clements
16. NAME of Father John Frances Clements
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Elizabeth Wadden
19. BIRTHPLACE Nova Scotia
20. Signature of Informant (Paul Burnett) for (Lennie) Clemets
address 128 Wiona Street, Glace Bay
Relationship to deceased Son
21. Place of burial South Head, Port Morien
Date of burial October 9, 1970
22. Undertaker Patten's Funeral Home, Glace Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 6, 1970
CAUSE OF DEATH
(a) Coronary Heart Disease
(b) Chronic Bronchitis
(c) Generalized atherosclerosis
other
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