Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Maria Alexandra Sampson death at Antigonish, Antigonish County on November 17, 1971
Female Death Registration: Year: 1971 number: 6552
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 006552
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 Sampson, Maria Alexandra
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE River Bourgeois, Richmond County
9. DATE OF BIRTH 1 31, 1901
10. AGE in Years70 Months9 Days17 | hrs or mins
11. Trade or profession Housewife
12. Kind of industry
13. Date last worked 14. Total years
15. If married name of spouse Deserie A. Sampson
16. NAME of Father Joseph D. Burke
17. BIRTHPLACE River Bourgeois, Richmond Co., NS
18. NAME of Mother Virginia Landry
19. BIRTHPLACE River Bourgeois, Richmond Co., NS
20. Signature of Informant Deserie A. Sampson
address River Bourgeois, Richmond Co., NS
Relationship to deceased Husband
21. Place of burial River Bourgeois Roman Catholic Cemetery, Richmond Co., NS
Date of burial 20 November 1971
22. Undertaker Alex A. Morrison, St. Peters, Richmond Co., NS
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 17, 1971
CAUSE OF DEATH
(a) Carcinomatosis from Anaplastic Carcinoma of Pancreas
(b)
(c)
other
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