Nova Scotia Archives
Nova Scotia Births, Marriages, and Deaths
Mark Gregory Samson death at Samsonville, Richmond County on December 29, 1971
Male Death Registration: Year: 1971 number: 7679
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007679
1. PLACE OF DEATH County of Richmond If in City or Town Samsonville
3. PRINT NAME OF DECEASED Samson, Mark Gregory
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
married
8. BIRTHPLACE Samsonville Nova Scotia
9. DATE OF BIRTH 8 8, 1913
10. AGE in Years58 Months4 Days21 | hrs or mins
11. Trade or profession Merchant
12. Kind of industry General Store
13. Date last worked Dec 24/71 14. Total years 30 years
15. If married name of spouse Mrs Eva Sampson
16. NAME of Father Joseph Gregory Samson
17. BIRTHPLACE River Bourgeois, Nova Scotia
18. NAME of Mother Mary Sampson
19. BIRTHPLACE River Bourgeois, Nova Scotia
20. Signature of Informant Catherine E. Sampson
address Lower L'Ardoise
Relationship to deceased Daughter
21. Place of burial St. Peter's (R.C. Cemetery)
Date of burial Dec 31, 1971
22. Undertaker Alex A. Morrison
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 29, 1971
CAUSE OF DEATH
(a) Coronary Thrombosis
(b) Arterial hypertension
(c)
other
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