Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Matilda Rose Belliveau death at Middle East Pubnico, Yarmouth County on September 13, 1971
Female Death Registration: Year: 1971 number: 5550
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005550
1. PLACE OF DEATH County of Yarmouth If in City or Town Middle East Pubnico
3. PRINT NAME OF DECEASED Belliveau, Matilda Rose
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Middle East Pubnico
9. DATE OF BIRTH 4 9, 1887
10. AGE in Years84 Months3 Days4 | hrs or mins
11. Trade or profession School Teacher
12. Kind of industry
13. Date last worked 1935 14. Total years 10 yrs
15. If married name of spouse
16. NAME of Father Joseph Leon Belliveau
17. BIRTHPLACE Middle East Pubnico, Yar. Co.
18. NAME of Mother Elizabeth Rosalie d'Entremont
19. BIRTHPLACE Middle East Pubnico, Yar. Co.
20. Signature of Informant Catherine d'Eon
address Middle East Pubnico
Relationship to deceased Sister
21. Place of burial Lower East Pubnico Cemetery
Date of burial Sept 15, 1971
22. Undertaker West Pubnico Funeral Service
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 13, 1971
CAUSE OF DEATH
(a) Hypostatic pneumonia
(b) Carcinomatosis
(c) Ca of bowel
other Senility, Cachexia
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