Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Carolyn Marie Stevens death at Pictou Island, Pictou County on July 26, 1971
Female Death Registration: Year: 1971 number: 5397
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005397
1. PLACE OF DEATH County of Pictou If in City or Town Pictou Island
If death occured in a hospital or institution At Beach, Pictou Landing
3. PRINT NAME OF DECEASED Stevens, Carolyn Marie
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Mi'kmaq
7. Single, Married
single
8. BIRTHPLACE Boston, Massachusetts, USA
9. DATE OF BIRTH 3 27, 1970
10. AGE in Years1 Months3 Days29 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Clifford Stevens
17. BIRTHPLACE NS.
18. NAME of Mother Jennie Nicholas
19. BIRTHPLACE NS.
20. Signature of Informant Clifford Stevens
address Pictou Landing
Relationship to deceased Father
21. Place of burial Pictou Landing
Date of burial July 28 - 71
22. Undertaker Angus, New Glasgow
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 26, 1971
CAUSE OF DEATH
(a) Drowning
(b)
(c)
other Accident
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