Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Lloyd Norval Pelton death at Kentville, Kings County on August 9, 1971
Male Death Registration: Year: 1971 number: 5049
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005049
1. PLACE OF DEATH County of Kings If in City or Town Kentville
If death occured in a hospital or institution N.S. Sanatorium
3. PRINT NAME OF DECEASED Pelton, Lloyd Norval
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 30, 1915
10. AGE in Years55 Months8 Days9 | hrs or mins
11. Trade or profession garage operator
12. Kind of industry
13. Date last worked Aug/69 14. Total years 25
15. If married name of spouse Elsie Pelton
16. NAME of Father Adolph Pelton
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Mabel Shaw
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Medical records NS Sanitorium
address
Relationship to deceased
21. Place of burial Nictaux, Anna. Co.
Date of burial August 11, 1971
22. Undertaker Warren T. Roop Ltd. Middleton, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 9, 1971
CAUSE OF DEATH
(a) acute cholecystitis with ruptured common duct, ? bile peritonitis, small with abnormal ridge bowel perforation (illegible)
(b) chronic cholecystitis
(c)
other Pulmonary TB of adolescent nature Chronic obstructive pulmonary disease
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