Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clayton Benjamin Stevens death at Lunenburg, Lunenburg County on October 30, 1970
Male Death Registration: Year: 1970 number: 6617
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006617
1. PLACE OF DEATH County of Lunenburg If in City or Town Lunenburg
If death occured in a hospital or institution Fisherman Memorial Hosp.
3. PRINT NAME OF DECEASED Stevens, Clayton Benjamin
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
widowed
8. BIRTHPLACE Big Tancook Island
9. DATE OF BIRTH 7 8, 1889
10. AGE in Years81 Months3 Days21 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Fisherman & Farmer
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Danniel Stevens
17. BIRTHPLACE Tancook Island
18. NAME of Mother Lillian Ausbury
19. BIRTHPLACE Cow Bay
20. Signature of Informant Roland Stevens
address Tancook
Relationship to deceased brother
21. Place of burial Tancook
Date of burial Nov 1, 1970
22. Undertaker Mahone Funeral Home, Mahone Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 30, 1970
CAUSE OF DEATH
(a) Hyperglycaemia
(b) Malnutrition
(c)
other Massive skin infection both legs
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