Nova Scotia Archives

Nova Scotia Births, Marriages, and Deaths

George Sampson death at New Waterford, Cape Breton County on February 16, 1970

Male Death Registration: Year: 1970 number: 1979

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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH

02 - 001979

1. PLACE OF DEATH   County of Cape Breton If in City or Town New Waterford
If death occured in a hospital or institution New Waterford Consolidated Hospital

3. PRINT NAME OF DECEASED Sampson, George

4. Sex

Male

5. Citizenship

Canadian

6. Racial Origin

French

7. Single, Married

married

8. BIRTHPLACE L'Ardoise

9. DATE OF BIRTH 6  3, 1886

10. AGE in  Years83  Months8  Days13 | hrs or mins

11. Trade or profession Coal miner

12. Kind of industry

13. Date last worked 1950       14. Total years

15. If married name of spouse Annie LaPierre

16. NAME of Father James  Sampson

17. BIRTHPLACE L'Ardoise

18. NAME of Mother Flora Carpenter

19. BIRTHPLACE Arishat

20. Signature of Informant Joseph Sampson

      address 7 Wood Ave., New Waterford

      Relationship to deceased Son

21. Place of burial Mt. Carmel Cemetery, New Waterford

      Date of burial February 18, 1970

22. Undertaker V. J. McGillivray Funeral Homes Ltd., New Waterford

MEDICAL CERTIFICATE OF DEATH

23. DATE OF DEATH February 16, 1970

CAUSE OF DEATH

(a) Arteriosclerotic heart disease

(b) Congestive heart failure

(c)

other

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