Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Alexander C. Samson death at D'Escousse, Richmond County on June 10, 1971
Male Death Registration: Year: 1971 number: 4458
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004458
1. PLACE OF DEATH County of Richmond If in City or Town D'Escousse
3. PRINT NAME OF DECEASED Samson, Alexander C.
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE d'Escousse, Rich. County
9. DATE OF BIRTH 7 27, 1884
10. AGE in Years86 Months10 Days14 | 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 Dianna Vergina
16. NAME of Father Gustin Samson
17. BIRTHPLACE d'Escousse, Rich. Co., NS
18. NAME of Mother Eliza Poirier
19. BIRTHPLACE d'Escousse, Rich. Co., NS
20. Signature of Informant Dianna Vergina Samson
address d'Escousse, Rich. Co., NS
Relationship to deceased Wife
21. Place of burial d'Escousse, Rich. Co., NS
Date of burial June 12, 1971
22. Undertaker C. Boucher, Arichat, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH June 10, 1971
CAUSE OF DEATH
(a) Myocardial Infarction
(b) Coronary Artery Disease
(c)
other
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