Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Percy Clark death at Pictou, Pictou County on September 24, 1971
Male Death Registration: Year: 1971 number: 5944
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005944
1. PLACE OF DEATH County of Pictou If in City or Town Pictou
3. PRINT NAME OF DECEASED Clark, Percy
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Grosse Isle, Quebec
9. DATE OF BIRTH 6 11, 1919
10. AGE in Years52 Months3 Days12 | hrs or mins
11. Trade or profession fisherman
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Gladys Clark
16. NAME of Father Simion Clark
17. BIRTHPLACE Grosse Isle, Quebec
18. NAME of Mother Letitia Sweet
19. BIRTHPLACE Grosse Isle, Quebec
20. Signature of Informant Mr. Walton Clark
address Abercrombie, R.R.#3, New Glasgow, Pictou Co.
Relationship to deceased brother
21. Place of burial Magdalen Island
Date of burial 27 Sep 1971
22. Undertaker R.H. Porter Funeral Homes Ltd
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 24, 1971
CAUSE OF DEATH
(a)
(b)
(c)
other
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