Male Death Registration: Year: 1970 number: 7104
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007104
1. PLACE OF DEATH County of Kings If in City or Town Wolfville
If death occured in a hospital or institution at home
3. PRINT NAME OF DECEASED Crouchman, George Lewis
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Wolfville
9. DATE OF BIRTH 10 24, 1969
10. AGE in Years1 Months0 Days3 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Charles Crouchman
17. BIRTHPLACE Wolfville
18. NAME of Mother Louise Salsman
19. BIRTHPLACE Kentville
20. Signature of Informant Mr. Charles Crouchman
address 86 Highland Avenue, Wolfville
Relationship to deceased Father
21. Place of burial Willowbank Cemetery, Wolfville
Date of burial October 30, 1970
22. Undertaker H. C. Lindsay Funeral Home, Wolfville
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 27, 1970
CAUSE OF DEATH
(a) Acute bronchiolitis
(b) None known
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=492410
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