Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Sarah Mombourquette death at Halifax, Halifax County on February 8, 1971
Female Death Registration: Year: 1971 number: 1552
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001552
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Basinview Home
3. PRINT NAME OF DECEASED Mombourquette, Sarah
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 10 27, 1884
10. AGE in Years86 Months3 Days12 | 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 Samuel Mombourquette
16. NAME of Father Pottie James
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Ranson Annie
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Harold Mombourquette
address 1056 Barrington Street, Halifax
Relationship to deceased Son
21. Place of burial Gate Of Heaven, Lower Sackville
Date of burial Feb 10, 1971
22. Undertaker J. Albert Walker
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH February 8, 1971
CAUSE OF DEATH
(a) ASHD
(b)
(c)
other Right Leg congenital deformity
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