Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Melvin Albert Sampson death at Antigonish, Antigonish County on March 7, 1970
Male Death Registration: Year: 1970 number: 2094
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002094
1. PLACE OF DEATH County of Antigonish If in City or Town Antigonish
If death occured in a hospital or institution St. Martha's Hospital
3. PRINT NAME OF DECEASED Sampson, Melvin Albert
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Louisdale
9. DATE OF BIRTH 12 31, 1913
10. AGE in Years56 Months2 Days4 | hrs or mins
11. Trade or profession Carpenter
12. Kind of industry Ralph Parson
13. Date last worked 14. Total years
15. If married name of spouse Cecilia Samson
16. NAME of Father Albert Sampson
17. BIRTHPLACE Louisdale
18. NAME of Mother Leona Sampson
19. BIRTHPLACE Louisdale
20. Signature of Informant Cecilia Sampson
address Louisdale
Relationship to deceased Wife
21. Place of burial Louisdale
Date of burial March 9, 1970
22. Undertaker C. A. Bauchin Funeral Home, Arichat
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 7, 1970
CAUSE OF DEATH
(a) Aortic myocardial infarction
(b)
(c)
other
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