Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Amy Leona Smith death at Clarks Harbour, Shelburne County on December 17, 1970
Female Death Registration: Year: 1970 number: 7497
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007497
1. PLACE OF DEATH County of Shelburne If in City or Town Clarks Harbour
3. PRINT NAME OF DECEASED Smith, Amy Leona
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
widowed
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 6 4, 1879
10. AGE in Years91 Months6 Days13 | hrs or mins
11. Trade or profession Housework
12. Kind of industry
13. Date last worked 1970 14. Total years 71
15. If married name of spouse Osborne Smith
16. NAME of Father Joseph Dixon
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Elizabeth Nickerson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Alton W. Crowell
address Clarks Harbour
Relationship to deceased Grandson
21. Place of burial Lower Clarks Harbour
Date of burial December 20, 1970
22. Undertaker Kenney Funeral Service
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 17, 1970
CAUSE OF DEATH
(a) Generalized and advanced arteriosclerosis
(b) Senility
(c)
other
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