Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Robert Lawrence Clark death at Granton, Pictou County on December 18, 1971
Male Death Registration: Year: 1971 number: 7670
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007670
1. PLACE OF DEATH County of Pictou If in City or Town Granton
3. PRINT NAME OF DECEASED Clark, Robert Lawrence
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
English
7. Single, Married
single
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 2 14, 1952
10. AGE in Years19 Months10 Days4 | hrs or mins
11. Trade or profession
12. Kind of industry Michelin Tire
13. Date last worked 1971 14. Total years 9 months
15. If married name of spouse
16. NAME of Father Fred Clark
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Grace Blaikie
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Fred Clark
address Meadowvale
Relationship to deceased Father
21. Place of burial Scotsburn
Date of burial December 20, 1971
22. Undertaker MacKenzie, Scotsburn
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 18, 1971
CAUSE OF DEATH
(a) Severed trachea, Brain damage and multiple fractures
(b)
(c)
other accident - 2 car accident (driver) head on collision
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