Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Arthur Gray Clark death at Halifax, Halifax County on October 30, 1971
Male Death Registration: Year: 1971 number: 6677
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006677
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Victoria General Hospital
3. PRINT NAME OF DECEASED Clark, Arthur Gray
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 7 16, 1951
10. AGE in Years20 Months3 Days14 | hrs or mins
11. Trade or profession Student
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother Catherine Joan Clark
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Thelma L. Clark
address Drummond Road, Westville, N. S.
Relationship to deceased Grandmother
21. Place of burial Auburn Cemetery, Westville, N. S.
Date of burial November 2, 1971
22. Undertaker Eagles Funeral Home, Westville, N. S.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 30, 1971
CAUSE OF DEATH
(a) Massive G. I. bleeding
(b) Leukemia
(c)
other
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