Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Marie Victoria Mombourquette death at Sydney, Cape Breton County on October 24, 1971
Female Death Registration: Year: 1971 number: 6331
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006331
1. PLACE OF DEATH County of Cape Breton If in City or Town Sydney
If death occured in a hospital or institution Spring Garden Villa, Sydney, NS
3. PRINT NAME OF DECEASED Mombourquette, Marie Victoria
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
widowed
8. BIRTHPLACE Rockdale, Richmond County
9. DATE OF BIRTH 4 29, 1876
10. AGE in Years95 Months5 Days25 | hrs or mins
11. Trade or profession Retired
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse James Mombourquette (deceased)
16. NAME of Father Patrick Pate
17. BIRTHPLACE River Bourgeois, Richmond Co., NS
18. NAME of Mother Margaret Wincey
19. BIRTHPLACE Rockdale, Richmond Co., NS
20. Signature of Informant Charles J. Mombourquette
address Rockdale, Richmond Co., NS
Relationship to deceased Son
21. Place of burial L'Ardoise Roman Catholic Cemetery
Date of burial 27 October 1971
22. Undertaker Alex A. Morrison, PO Box 10, St. Peters, Richmond Co., NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH October 24, 1971
CAUSE OF DEATH
(a) Arteriosclerosis with Cardiac Disease
(b) Senility
(c)
other
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