Female Death Registration: Year: 1971 number: 1101
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001101
1. PLACE OF DEATH County of Cape Breton If in City or Town Glace Bay
If death occured in a hospital or institution St. Joseph's Hospital
3. PRINT NAME OF DECEASED McMullin, Madonna Marie
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE Springhill
9. DATE OF BIRTH 1 14, 1894
10. AGE in Years76 Months11 Days28 | hrs or mins
11. Trade or profession Household Duties
12. Kind of industry At Home
13. Date last worked 5 months ago 14. Total years Life
15. If married name of spouse Archie McMullin (dec.)
16. NAME of Father Eugene Gouthro
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Mary Margaret McCarron
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mrs. John McKenzie
address 35 Winslow St., Everett, Mass.
Relationship to deceased Daughter
21. Place of burial St. Eugene Cemetery, Dominion, NS
Date of burial January 14 , 1971
22. Undertaker V. J. McGillivray Funeral Homes Ltd., Resere St., Glace Bay
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 11, 1971
CAUSE OF DEATH
(a) Congestive Cardiac Failure
(b) Diabetes
(c) Atrial Flutter
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=493179
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