Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
St. Clair Alma Burgess death at Windsor, Hants County on September 24, 1971
Male Death Registration: Year: 1971 number: 6024
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006024
1. PLACE OF DEATH County of Hants If in City or Town Windsor
If death occured in a hospital or institution Payzant Memorial Hospital
3. PRINT NAME OF DECEASED Burgess, St. Clair Alma
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
divorced
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 24, 1887
10. AGE in Years83 Months11 Days0 | hrs or mins
11. Trade or profession Welder
12. Kind of industry Construction
13. Date last worked 1960 14. Total years 40
15. If married name of spouse
16. NAME of Father Watson Burgess
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Phobe Boutilier
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Mary Lanford R.N.
address Masonic Home, Windsor
Relationship to deceased Nurse
21. Place of burial Maplewood Cemetery, Windsor
Date of burial September 27, 1971
22. Undertaker Lohnes Funeral Service Ltd. Windsor
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 24, 1971
CAUSE OF DEATH
(a) Cardiosclerosis
(b) Arteriosclerosis
(c)
other
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