Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Mary Veronica Sampson death at Halifax, Halifax County on May 9, 1971
Female Death Registration: Year: 1971 number: 3262
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003262
1. PLACE OF DEATH County of Halifax If in City or Town Halifax
If death occured in a hospital or institution Halifax Infirmary
3. PRINT NAME OF DECEASED Sampson, Mary Veronica
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French Caucasian
7. Single, Married
widowed
8. BIRTHPLACE L'Ardoise
9. DATE OF BIRTH 11 7, 1904
10. AGE in Years66 Months6 Days2 | 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 Dominic Edward Sampson - deceased
16. NAME of Father Daniel Briand
17. BIRTHPLACE L'Ardoise
18. NAME of Mother Julia LeRue
19. BIRTHPLACE L'Ardoise
20. Signature of Informant P. Sampson
address 30 Brule St, Dartmouth, NS
Relationship to deceased Son
21. Place of burial L'Ardoise Roman Catholic Cemetery
Date of burial May 12, 1971
22. Undertaker Alex A. Morrison, St. Peters, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 9, 1971
CAUSE OF DEATH
(a) Ischemic Heart Disease
(b) Thoracic Aortic Aneurysm
(c)
other
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