Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Angelique Grace Melanson death at Antigonish, Antigonish County on October 1, 1971
Female Death Registration: Year: 1971 number: 5992
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 005992
1. PLACE OF DEATH County of Antigonish If in City or Town Antigonish
If death occured in a hospital or institution St. Martha's Hospital, Antigonish, NS
3. PRINT NAME OF DECEASED Melanson, Angelique Grace
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Caucasian
7. Single, Married
8. BIRTHPLACE Nova Scotia
9. DATE OF BIRTH 3 5, 1895
10. AGE in Years76 Months6 Days26 | hrs or mins
11. Trade or profession
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse
16. NAME of Father William Melanson
17. BIRTHPLACE NS
18. NAME of Mother Angelique Anne Dorion
19. BIRTHPLACE NS
20. Signature of Informant Clarence DeWolfe
address Pomquet, Antigonish Co., NS.
Relationship to deceased Nephew
21. Place of burial Holy Cross RC Cemetery, Pomquet NS
Date of burial 5 Oct. 1971
22. Undertaker Curry Bros Funeral Director Ltd.
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 1, 1971
CAUSE OF DEATH
(a) Bronchial pneumonia
(b)
(c)
other Carcinoma of Face
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