Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Donna Elizabeth Crocker death at Fort Lawrence, Cumberland County on March 2, 1971
Female Death Registration: Year: 1971 number: 2258
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002258
1. PLACE OF DEATH County of Cumberland If in City or Town Fort Lawrence
If death occured in a hospital or institution at home
3. PRINT NAME OF DECEASED Crocker, Donna Elizabeth
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 9 30, 1966
10. AGE in Years4 Months5 Days2 | 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 Clyde Crocker
17. BIRTHPLACE NS
18. NAME of Mother Elizabeth Sutherland
19. BIRTHPLACE NS
20. Signature of Informant Clyde Crocker
address Fort Lawrence, NS
Relationship to deceased Father
21. Place of burial Upper Musquodobit
Date of burial Mar 5, 1971
22. Undertaker Ettinger Funeral Service Ltd
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 2, 1971
CAUSE OF DEATH
(a) Fracture dislocation of D4 (thoracic vertebrae)
(b) Dslocation of cervical vertebrae 2 and 3
(c) shock
other Accident: fell into silo conveyor
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