Female Death Registration: Year: 1971 number: 5862
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005862
1. PLACE OF DEATH County of Annapolis If in City or Town Nictaux
If death occured in a hospital or institution residence, Nictaux
3. PRINT NAME OF DECEASED Collard, Helene Marie
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Belgian
7. Single, Married
widowed
8. BIRTHPLACE Belgium
9. DATE OF BIRTH 6 21, 1894
10. AGE in Years77 Months3 Days3 | hrs or mins
11. Trade or profession housewife
12. Kind of industry
13. Date last worked September 1971 14. Total years life
15. If married name of spouse Camille Victorien Collard
16. NAME of Father
17. BIRTHPLACE
18. NAME of Mother
19. BIRTHPLACE
20. Signature of Informant Hanson C. Dowell
address Middleton, Annapolis Co., NS
Relationship to deceased
21. Place of burial Kingston, Kings Co., NS
Date of burial September 27, 1971
22. Undertaker Warren T. Roop, Ltd. Middleton, NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH September 24, 1971
CAUSE OF DEATH
(a) unknown. presumed CVA or myocardial infarction
(b)
(c)
other Cerebral Atherosclerosis; hypertension
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=497936
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