Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Raymond H Sampson death at Sydney, Cape Breton County on March 4, 1971
Male Death Registration: Year: 1971 number: 2367
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 002367
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution St Rita Hospital
3. PRINT NAME OF DECEASED Sampson, Raymond H
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
separated
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 2 24, 1894
10. AGE in Years77 Months Days8 | 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 Mrs Deborah Sampson
16. NAME of Father Henry Sampson
17. BIRTHPLACE Lower L'Ardoise, Nova Scotia
18. NAME of Mother Mary Landry
19. BIRTHPLACE L'Ardoise, Nova Scotia
20. Signature of Informant Quinton Sampson
address Lower L'Ardoise
Relationship to deceased Friend
21. Place of burial L'Ardoise R C Cemetery
Date of burial March 7, 1971
22. Undertaker Alex Morrison, St Peters, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH March 4, 1971
CAUSE OF DEATH
(a) Coronary Thrombosis
(b) Coronary Ischemia
(c)
other Gastrectomy
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