Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Alphonse Mombourquette death at New Waterford, Cape Breton County on March 5, 1971
Male Death Registration: Year: 1971 number: 2240
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002240
1. PLACE OF DEATH County of Cape Breton If in City or Town New Waterford
If death occured in a hospital or institution #12 Colliery
3. PRINT NAME OF DECEASED Mombourquette, Alphonse
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Cheticamp
9. DATE OF BIRTH 4 5, 1931
10. AGE in Years39 Months11 Days0 | hrs or mins
11. Trade or profession Coal Miner
12. Kind of industry
13. Date last worked 1971 14. Total years
15. If married name of spouse Mary Ropek
16. NAME of Father Simon Mombourquette
17. BIRTHPLACE L'Airdois, NS
18. NAME of Mother Josephine Aucoin
19. BIRTHPLACE Cheticamp, NS
20. Signature of Informant Mary Mombourquette
address 16 Spruce Street, New Waterford
Relationship to deceased Wife
21. Place of burial St. Agnes Cemetery, New Waterford, NS
Date of burial March 8, 1971
22. Undertaker W.J. McGillivray Funeral Homes Limited, New Waterford, Nova Scotia
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 5, 1971
CAUSE OF DEATH
(a) Dead on arrival
(b)
(c)
other
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