Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Alexina Mombourquette death at Antigonish, Antigonish County on October 23, 1970
Female Death Registration: Year: 1970 number: 6264
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006264
1. PLACE OF DEATH County of Antigonish If in City or Town Antigonish
If death occured in a hospital or institution St. Martha Hospital
3. PRINT NAME OF DECEASED Mombourquette, Alexina
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE Cape Breton
9. DATE OF BIRTH 12 23, 1890
10. AGE in Years79 Months10 Days | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Albert Poirier
17. BIRTHPLACE Cape Breton
18. NAME of Mother Agnes Cordeau
19. BIRTHPLACE Cape Breton
20. Signature of Informant Joe Mombourquette
address 104 York St., Sydney
Relationship to deceased son
21. Place of burial Holy Cross Cemetery
Date of burial Oct 26, 1970
22. Undertaker T.V. Curry Limited, Sydney
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 23, 1970
CAUSE OF DEATH
(a) Head injury (compound fracture maxilla and nose)
(b) Auto accident
(c)
other Compound fracture right ankle, fracture ribs right, fracture wrist left, fracture ankle left
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