Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Martin Louis Pellerine death at Larrys River, Guysborough County on May 24, 1971
Male Death Registration: Year: 1971 number: 3685
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003685
1. PLACE OF DEATH County of Guysborough If in City or Town Larrys River
3. PRINT NAME OF DECEASED Pellerine, Martin Louis
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE Larry's River
9. DATE OF BIRTH 11 9, 1872
10. AGE in Years98 Months6 Days15 | hrs or mins
11. Trade or profession Pensioner
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father Louis Pellerine
17. BIRTHPLACE Larry's River
18. NAME of Mother Angeline Belfontaine
19. BIRTHPLACE Antigonish County
20. Signature of Informant Mrs. J. Skinner
address Windsor, Ontario
Relationship to deceased Daughter
21. Place of burial Larry's River, NS
Date of burial May 26, 1971
22. Undertaker Nathan Rhynold
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH May 24, 1971
CAUSE OF DEATH
(a) Pneumonia
(b) Extreme old age and senility
(c)
other
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