Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Gordon Winslow Custance death at Shubenacadie, Hants County on August 19, 1971
Male Death Registration: Year: 1971 number: 5378
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005378
1. PLACE OF DEATH County of Hants If in City or Town Shubenacadie
If death occured in a hospital or institution at home
3. PRINT NAME OF DECEASED Custance, Gordon Winslow
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Nine Mile River, Hants County
9. DATE OF BIRTH 8 8, 1885
10. AGE in Years86 Months0 Days11 | hrs or mins
11. Trade or profession Farmer
12. Kind of industry Retired
13. Date last worked 1945 14. Total years Life
15. If married name of spouse Loey Custance
16. NAME of Father Wesley Custance
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Mary Ann Brochon
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Ann Cotton
address Shubenacadie
Relationship to deceased Daughter
21. Place of burial Sand Hill Cemetery, Nine Mile River
Date of burial Aug 21, 1971
22. Undertaker Ettinger Funeral Service Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH August 19, 1971
CAUSE OF DEATH
(a) Cerebral Vascular Accident
(b) Generalized atherosclerosis
(c) Diabetes
other
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