Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Louise M. Forest death at Arichat, Richmond County on July 20, 1971
Female Death Registration: Year: 1971 number: 4694
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 004694
1. PLACE OF DEATH County of Richmond If in City or Town Arichat
If death occured in a hospital or institution St. Ann Hospital, Arichat, NS
3. PRINT NAME OF DECEASED Forest, Louise M.
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE West Arichat, Rich. County
9. DATE OF BIRTH 12 14, 1889
10. AGE in Years81 Months7 Days6 | 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 Jeffrey Forgeron
17. BIRTHPLACE West Arichat, Rich. Co., NS
18. NAME of Mother Ann Fougere
19. BIRTHPLACE West Arichat, Rich. Co., NS
20. Signature of Informant Mrs. Alphonce Marchand
address Arichat, Rich. Co., NS
Relationship to deceased Niece
21. Place of burial West Arichat
Date of burial July 22, 1971
22. Undertaker C. A. Boucher Funeral Home, Arichat, Rich. Co., NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH July 20, 1971
CAUSE OF DEATH
(a) Cerebrovascular Accident
(b) Myocardial Insufficiency
(c) Coronary Insufficiency
other Diabetes and Hypertension
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