Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Kimberley Dawn MacDougall death at Pictou, Pictou County on November 25, 1971
Female Death Registration: Year: 1971 number: 7319
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007319
1. PLACE OF DEATH County of Pictou If in City or Town Pictou
If death occured in a hospital or institution Crib Death
3. PRINT NAME OF DECEASED MacDougall, Kimberley Dawn
4. Sex
Female
5. Citizenship
Canadian
6. Racial Origin
Scottish
7. Single, Married
8. BIRTHPLACE Pictou
9. DATE OF BIRTH 11 22, 1971
10. AGE in Years Months Days3 | 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 Lyle MacDougall
17. BIRTHPLACE Nova Scotia
18. NAME of Mother Mary Etta Height
19. BIRTHPLACE Nova Scotia
20. Signature of Informant Mr. Lyle MacDougall
address 42 Elm St
Relationship to deceased Father
21. Place of burial Stella Maris, Pictou
Date of burial November 26, 1971
22. Undertaker McLaren Funeral Home
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH November 25, 1971
CAUSE OF DEATH
(a)
(b)
(c)
other
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