Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
John Clayton Crouse death at Lunenburg, Lunenburg County on December 10, 1971
Male Death Registration: Year: 1971 number: 7313
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007313
1. PLACE OF DEATH County of Lunenburg If in City or Town Lunenburg
If death occured in a hospital or institution Fisherman's Memorial Hospital
3. PRINT NAME OF DECEASED Crouse, John Clayton
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
married
8. BIRTHPLACE Crouses Settlement
9. DATE OF BIRTH 8 5, 1896
10. AGE in Years75 Months4 Days5 | hrs or mins
11. Trade or profession Engine Fitter
12. Kind of industry Lunenburg Foundry
13. Date last worked 1964 14. Total years 30
15. If married name of spouse Hilda Crouse
16. NAME of Father Simon Crouse
17. BIRTHPLACE Lunenburg
18. NAME of Mother Sophia Mailman
19. BIRTHPLACE Lunenburg
20. Signature of Informant Basil Crouse
address Lunenburg
Relationship to deceased Son
21. Place of burial Lunenburg
Date of burial December 12, 1971
22. Undertaker Dana L. Sweeny, Lunenburg
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 10, 1971
CAUSE OF DEATH
(a) Uremia
(b)
(c)
other
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