Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Percy Charles Sampson death at River Bourgeois, Richmond County on June 6, 1971
Male Death Registration: Year: 1971 number: 3810
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 003810
1. PLACE OF DEATH County of Richmond If in City or Town River Bourgeois
3. PRINT NAME OF DECEASED Sampson, Percy Charles
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Arichat
9. DATE OF BIRTH 10 18, 1951
10. AGE in Years19 Months7 Days18 | hrs or mins
11. Trade or profession Student
12. Kind of industry St. Mary's University
13. Date last worked 14. Total years 1
15. If married name of spouse
16. NAME of Father Joseph Vincent Sampson
17. BIRTHPLACE River Bourgeois
18. NAME of Mother Rachel Milda Burke
19. BIRTHPLACE South River Bourgeois
20. Signature of Informant Vincent Sampson
address River Bourgeois
Relationship to deceased Father
21. Place of burial River Bourgeois R C Cemetery
Date of burial June 10, 1971
22. Undertaker Alex A. Morrison, St. Peter's NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 6, 1971
CAUSE OF DEATH
(a) Drowning
(b)
(c)
other Accident: fell overboard, small sailboat
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