Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Mervin Wilfred Cleveland death at Halifax, Halifax County on January 13, 1971
Male Death Registration: Year: 1971 number: 1174
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001174
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary
3. PRINT NAME OF DECEASED Cleveland, Mervin Wilfred
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Blandford
9. DATE OF BIRTH 10 10, 1906
10. AGE in Years64 Months3 Days3 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Fish-handler
13. Date last worked 1968 14. Total years 35
15. If married name of spouse Mabel Cleveland
16. NAME of Father David Cleveland
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Ada N/A
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Kenneth Cleveland
address Brookside, R.R.#2, Avondale
Relationship to deceased Son
21. Place of burial Camp Bill
Date of burial January 15, 1971
22. Undertaker Cruickshank Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 13, 1971
CAUSE OF DEATH
(a) Chronic Obstructive ? Lung Disease
(b) Pleural Effusion
(c) Lung Malignancy
other Chronic Asthmatic Bronchitis
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