Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Basil Leroy Underwood death at Five Mile River, Hants County on December 3, 1970
Male Death Registration: Year: 1970 number: 7103
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007103
1. PLACE OF DEATH County of Hants If in City or Town Five Mile River
If death occured in a hospital or institution on highway
3. PRINT NAME OF DECEASED Underwood, Basil Leroy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 2 27, 1922
10. AGE in Years48 Months9 Days6 | hrs or mins
11. Trade or profession Labourer
12. Kind of industry
13. Date last worked 3 Dec '70 14. Total years Life
15. If married name of spouse Phyllis Underwood
16. NAME of Father Wm Underwood
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Helen McLaren
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Basil Underwood
address Five Mile River
Relationship to deceased Wife
21. Place of burial Five Mile River
Date of burial 5 Dec 1970
22. Undertaker Ettinger Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 3, 1970
CAUSE OF DEATH
(a) Internal injuries, rupture liver, spleen and right lung
(b)
(c)
other Accident - driver in 2-car collision
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