Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Mary Euphrem Rose death at Lyons Brook, Pictou County on September 13, 1970
Female Death Registration: Year: 1970 number: 5922
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005922
1. PLACE OF DEATH County of Pictou If in City or Town Lyons Brook
If death occured in a hospital or institution Forbes Rest Home
3. PRINT NAME OF DECEASED Rose, Mary Euphrem
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
widowed
8. BIRTHPLACE Prince Edward Island
9. DATE OF BIRTH 4 16, 1886
10. AGE in Years84 Months4 Days28 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse William Rose
16. NAME of Father John MacKenzie
17. BIRTHPLACE Prince Edward Island
18. NAME of Mother Johanna MacKay
19. BIRTHPLACE Scotland
20. Signature of Informant Mrs Margaret MacNaughton
address Scotsburn
Relationship to deceased Daughter
21. Place of burial West St Peters, Prince Edward Island
Date of burial 16 Sept 1970
22. Undertaker MacKenzie Funeral Service, Scotsburn
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 13, 1970
CAUSE OF DEATH
(a)
(b)
(c)
other
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