Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Daniel Stewart Clark death at New Glasgow, Pictou County on February 10, 1971
Male Death Registration: Year: 1971 number: 1800
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001800
1. PLACE OF DEATH County of Pictou If in City or Town New Glasgow
If death occured in a hospital or institution 361 Temperance Street
3. PRINT NAME OF DECEASED Clark, Daniel Stewart
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
7. Single, Married
single
8. BIRTHPLACE West River (Pictou County)
9. DATE OF BIRTH 1 21, 1907
10. AGE in Years64 Months Days20 | hrs or mins
11. Trade or profession Machinist
12. Kind of industry T.I.D.
13. Date last worked 1971 14. Total years 25
15. If married name of spouse
16. NAME of Father George William Clark
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Jessie Jane Joudrey
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Charles Wyman
address 361 Temperance Street, New Glasgow
Relationship to deceased Sister
21. Place of burial Durham Cemetery, Pictou Co.
Date of burial February 13, 1971
22. Undertaker Angus, New Glasgow
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 10, 1971
CAUSE OF DEATH
(a) Pulmonary obstruction
(b) Laryngeal paralysis
(c) Old polio
other Chronic bronchitis & ?laryngitis
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