Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Donald Gerrish Clements death at Middleton, Annapolis County on May 16, 1971
Male Death Registration: Year: 1971 number: 3557
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003557
1. PLACE OF DEATH County of Annapolis If in City or Town Middleton
If death occured in a hospital or institution Soldiers Memorial Hospital
3. PRINT NAME OF DECEASED Clements, Donald Gerrish
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
African
7. Single, Married
single
8. BIRTHPLACE Inglewood
9. DATE OF BIRTH 12 14, 1914
10. AGE in Years56 Months5 Days2 | hrs or mins
11. Trade or profession Veteran 1939-45
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Abram Clements
17. BIRTHPLACE NS
18. NAME of Mother Bertha States
19. BIRTHPLACE NS
20. Signature of Informant Charles A. Clements
address Inglewood, NS
Relationship to deceased Brother
21. Place of burial Bridgetown, NS
Date of burial March 19, 1971
22. Undertaker Bridgetown Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 16, 1971
CAUSE OF DEATH
(a) Coronary Thrombosis
(b) Hypertension
(c) Arteriosclerosis
other
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Note: African Nova Scotian