Female Death Registration: Year: 1970 number: 6621
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006621
1. PLACE OF DEATH County of Lunenburg If in City or Town Lunenburg
If death occured in a hospital or institution on Highway
3. PRINT NAME OF DECEASED Burgoyne, Annie Minnie
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
German
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 2 27, 1907
10. AGE in Years63 Months8 Days11 | hrs or mins
11. Trade or profession At Home
12. Kind of industry
13. Date last worked 1970 14. Total years 40
15. If married name of spouse Clayton Burgoyne
16. NAME of Father William Oickle
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Minnie Zinck
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. Howard Burgoyne
address Springfield R.R. 3
Relationship to deceased sister
21. Place of burial Ninevah
Date of burial November 9 1970
22. Undertaker Langille's Funeral Home, Barss Corner
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 7, 1970
CAUSE OF DEATH
(a) Brain Haemorrhage
(b) Fractured Skull
(c) Car Accident
other Multiple Fractures
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/
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