Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Harvey St. Clair Crouse death at Halifax, Halifax County on March 30, 1971
Male Death Registration: Year: 1971 number: 2501
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002501
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 Crouse, Harvey St. Clair
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Caucasian
7. Single, Married
married
8. BIRTHPLACE Lunenburg County
9. DATE OF BIRTH 5 1, 1891
10. AGE in Years79 Months10 Days29 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Helen Crouse
16. NAME of Father Henry Crouse
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Emma Grimm
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Helen Crouse
address 5565 Cogswell St., Halifax
Relationship to deceased Wife
21. Place of burial Upper LaHave, Lunenburg Co.
Date of burial April 2, 1971
22. Undertaker Charles Sweeney, Bridgewater
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 30, 1971
CAUSE OF DEATH
(a) Cardio-Respiratory Failure
(b) Cancer Stomach
(c) Pulmonary Embolism
other
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