Male Death Registration: Year: 1971 number: 7694
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PROVINCE OF NOVA SCOTIA — REGISTRATION OF DEATH
02 - 007694
1. PLACE OF DEATH County of Inverness If in City or Town Cheticamp
If death occured in a hospital or institution Sacred Heart Hospital
3. PRINT NAME OF DECEASED Bourgeois, Arsene
4. Sex
Male
5. Citizenship
Canadian
6. Racial Origin
French
7. Single, Married
single
8. BIRTHPLACE Cheticamp
9. DATE OF BIRTH 1 23, 1885
10. AGE in Years86 Months10 Days29 | 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
16. NAME of Father Jean Bourgeois
17. BIRTHPLACE Cheticamp
18. NAME of Mother Suzanne Deveau
19. BIRTHPLACE St. Joseph du Moine
20. Signature of Informant Gloria LeBlanc R.N.
address Belle Cote
Relationship to deceased
21. Place of burial Cheticamp
Date of burial December 24, 1971
22. Undertaker Louis L. Chiasson and Son, Cheticamp
MEDICAL CERTIFICATE OF DEATH
23. DATE OF DEATH December 22, 1971
CAUSE OF DEATH
(a) Cardio Renal Vasculor
(b)
(c)
other
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Nova Scotia Archives — https://archives.novascotia.ca/vital-statistics/death/?ID=499766
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