Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Agnes Mary Cluett death at Sydney Mines, Cape Breton County on October 29, 1971
Female Death Registration: Year: 1971 number: 6333
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006333
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney Mines
If death occured in a hospital or institution Harbour View Hospital, Sydney Mines
3. PRINT NAME OF DECEASED Cluett, Agnes Mary
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Sydney Mines, Cape Breton County
9. DATE OF BIRTH 1 17, 1893
10. AGE in Years78 Months9 Days12 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry Housekeeping
13. Date last worked July 1971 14. Total years 55 years
15. If married name of spouse Jacob Cluett
16. NAME of Father John Carmichael
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Flora Ferguson
19. BIRTHPLACE Nova Scotia
20. Signature of Informant __________?
address Granville Street, Port Hawkesbury, NS
Relationship to deceased Son
21. Place of burial St. Andrews Cemetery, Sydney Mines, NS
Date of burial 1 November 1971
22. Undertaker Fillmore & Whitman Funeral Home Ltd., Sydney Mines, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 29, 1971
CAUSE OF DEATH
(a) Uraemia
(b) Carcinoma of Colon
(c)
other
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