Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Henrietta Jane MacKenzie death at Sydney, Cape Breton County on May 16, 1970
Female Death Registration: Year: 1970 number: 3468
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003468
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution St. Rita Hospital
3. PRINT NAME OF DECEASED MacKenzie, Henrietta Jane
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE River Bourgeois
9. DATE OF BIRTH 10 13, 1876
10. AGE in Years93 Months7 Days3 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Norman MacKenzie (deceased)
16. NAME of Father Louis Bernard Boucher
17. BIRTHPLACE River Bourgeois
18. NAME of Mother Harriett Jane Sampson
19. BIRTHPLACE River Bourgeois
20. Signature of Informant Joseph Roddie MacKenzie
address St. Peters
Relationship to deceased Son
21. Place of burial St. Peters Roman Catholic Cemetery
Date of burial May 19, 1970
22. Undertaker Alex A. Morrison, St. Peters
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 16, 1970
CAUSE OF DEATH
(a) Hypostatic Bronchopneumonia
(b)
(c)
other
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