Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Jean Regine Clark death at Halifax, Halifax County on November 21, 1971
Female Death Registration: Year: 1971 number: 6699
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006699
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution V G Hospital
3. PRINT NAME OF DECEASED Clark, Jean Regine
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
married
8. BIRTHPLACE Dartmouth
9. DATE OF BIRTH 1 18, 1908
10. AGE in Years63 Months10 Days3 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry At home
13. Date last worked July 1971 14. Total years 35
15. If married name of spouse Mr Ray Clark
16. NAME of Father Arthur Dunbrack
17. BIRTHPLACE Dartmouth, NS
18. NAME of Mother Clara Turple
19. BIRTHPLACE Clam Bay, Halifax Co
20. Signature of Informant Mry Ray Clark
address 2497 St Mathias St, Halifax
Relationship to deceased Husband
21. Place of burial St Marks Cem, Porters Lake
Date of burial Nov 23, 1971
22. Undertaker Cruikshanks Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 21, 1971
CAUSE OF DEATH
(a)
(b)
(c)
other
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