Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Clarence Victor Jollimore death at Milton, Queens County on October 12, 1971
Male Death Registration: Year: 1971 number: 6054
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006054
1. PLACE OF DEATH County of Queens If in City or Town Milton
If death occured in a hospital or institution Acute Myocardial Infarction
3. PRINT NAME OF DECEASED Jollimore, Clarence Victor
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Milton, Queens County
9. DATE OF BIRTH 3 16, 1913
10. AGE in Years58 Months6 Days26 | hrs or mins
11. Trade or profession Storage Man
12. Kind of industry Bowater Mersey Paper Co.
13. Date last worked 11 October 1971 14. Total years 30 years
15. If married name of spouse Elsie Irene Jollimore
16. NAME of Father James I. Jollimore
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Minnie Wolfe
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Arnold B. Jollimore
address Hillside Road, Liverpool, Queens Co., NS
Relationship to deceased Son
21. Place of burial Milton, Queens Co., NS
Date of burial 15 October 1971
22. Undertaker Chandlers' Funeral Service Ltd., Liverpool, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 12, 1971
CAUSE OF DEATH
(a) Coronary Artery Disease
(b)
(c)
other
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