Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Percy Leroy Cook death at Yarmouth, Yarmouth County on July 17, 1971
Male Death Registration: Year: 1971 number: 4700
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004700
1. PLACE OF DEATH County of Yarmouth If in City or Town Yarmouth
If death occured in a hospital or institution Yarmouth Hospital
3. PRINT NAME OF DECEASED Cook, Percy Leroy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Wellington, Yar. County Nova Scotia
9. DATE OF BIRTH 9 29, 1891
10. AGE in Years79 Months9 Days18 | hrs or mins
11. Trade or profession Retired
12. Kind of industry Clothing store owner
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Herbert C. Cook
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Margaret Pitman
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Ruth Frampton
address Wellington, Yar. Co., NS
Relationship to deceased Sister
21. Place of burial Hebron, Yar. Co,, NS
Date of burial July 19, 1971
22. Undertaker Sweeny's Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 17, 1971
CAUSE OF DEATH
(a) Cerebral Vascular Accident
(b) Arteriosclerotic Heart Disease
(c)
other
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