Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Alice Mary Pelerine death at Hazel Hill, Guysborough County on January 24, 1971
Female Death Registration: Year: 1971 number: 1618
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 001618
1. PLACE OF DEATH County of Guysborough If in City or Town Hazel Hill
If death occured in a hospital or institution Hazel Hill Rest Home
3. PRINT NAME OF DECEASED Pelerine, Alice Mary
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE Charlos Cove
9. DATE OF BIRTH 11 1, 1888
10. AGE in Years82 Months2 Days23 | 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 Angus Pelerine
16. NAME of Father Luke Richard
17. BIRTHPLACE Guysborough Co.
18. NAME of Mother Nancy Boudreau
19. BIRTHPLACE Guysborough, NS
20. Signature of Informant Velma Beaumont, RN
address Hazel Hill Rest Home, RR #1, Canso, NS
Relationship to deceased Supt. of Home
21. Place of burial Larry's River, NS
Date of burial January 26, 1971
22. Undertaker Nathan Rhynold, Philips Harbour, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH January 24, 1971
CAUSE OF DEATH
(a) Uraemia
(b) Chronic renal failure
(c)
other
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