Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clement Disnard death at Halifax, Halifax County on September 30, 1971
Male Death Registration: Year: 1971 number: 5821
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005821
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary
3. PRINT NAME OF DECEASED Disnard, Clement
4. Sex
Male
5. Citizenship
French
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE St. Pierre et Miquelon
9. DATE OF BIRTH 12 7, 1898
10. AGE in Years72 Months9 Days23 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Theresa
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Mrs. Theresa Disnard
address St. Pierre et Miquelon
Relationship to deceased Wife
21. Place of burial St. Pierre et Miquelon
Date of burial 5 October 1971
22. Undertaker Snow & Co. Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 30, 1971
CAUSE OF DEATH
(a) Confluent Bronchopneumonia
(b) Retroperitoneal Carcinoma
(c) Generalized Arteriosclerosis
other
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