Town of Winthrop : Record of Deaths 1928-1930, Part 3

Author: Winthrop (Mass.)
Publication date: 1928
Publisher:
Number of Pages: 1296

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1928-1930 > Part 3

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R-301

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

BOSTON

(City or town) Registered No. 1162 7-

City or Town

Dustun Winthrop

No.

949 Shirley Street, Winthropst Ward (If death occurred in a hospital or institution, give its NAME instead of street and number)

2FULL NAME Thomas F. Meagher

(If U. S. War Veteran, specify WAR)

(a) Residence. No.

949 Shirley Street

St.,

Ward,

(if non-resident give city or town and state)

Length of residence in city or town where death occurred 2 years months

days. How long in U. S., if of foreign birth? 6 years months days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word)

Male

White

Single

5a if married, widowed cr divorced HUSBAND of (or) WIFE of

6 AGE

Years

Months

Days

IF LESS than 1 day ......... hrs. cr ........ min.

IF STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

Blacksmith

(b) Name of employer

8 BIRTHPLACE (City)

Halifax,

(State or country)

Nova Scotia

9 NAME OF FATHER John Meagher

PARENTS

10 BIRTHPLACE OF

FATHER (City)

(State or country) Ireland

1 1 MAIDEN NAME OF MOTHER Ellen Condon

12 BIRTHPLACE OF MOTHER (City) (State or country) Ireland

Informant John Meagher

(Address)

949 Shirley Street Winthrop

14 Filed (month) (Day) (Year)

REGISTRAR

20 | HEREBY CERTIFY that a satisfactory stan- dard certificate of death was filed with me BEFORE the burial or transit permit was issued/

No. D. Childress 4.8).

Official Health Officer

Date of issue

1/12/28 Permit Tlc. 1353

200.000. 9-26. NO. 6373

Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. plied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so that it may be properly classified.

27-2011

CONTRIBUTORY (Secondary) Senility

(duration).

_. yrs.

mos. ds.

17 Where was disease contracted if not at place of death

Did an operation precede death

For what

Date of operation

Was there an autopsy

What test confirmed diagnosis

If under one your, was infortreasurede

(Signed) Jacob Abramo BEM N.D.

(Address) 362 Salirley Street

Date 11, 1928.

18 PLACE OF BURIAL, CREMATION, OR REMOVAL' DATE OF BURIAL Jan 12,1928

St. Josephs Boston

(Cemetery) (City or town)

19 UNDERTAKER

ADDRESS East Boston

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH January 10 (Month)

1928

(Day)

(Year)

I HEREBY CERTIFY , That I attended deceased from

July

1927, to

January 10

1928

that I last saw h wenn _alive on

19.2,

and that death occurred, on the date stated above, at

7:30 p m. The CAUSE OF DEATH was as follows: (State fully)

Clironic Interstitial heplantes

duration)

_yrs. .mos ds.

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS 1 PLACE OF DEATH County Suffolk

State

Massachusetts

(Usua! place of abode)

6/28

Jan, 10,1928 REVISED UNITED STATESSTANDARD CERTIFICATE OF DEATH

(Approved by U. S. Census and American Public Health Association)

EXTRACTS

FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS

GOVERNING THE

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Com- positor, Architect, Locomotive engineer, Civil engineer, Stationary fire- man, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter statement; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second statement. Never return "Laborer," "Fore- man," "Manager," "Dealer," etc., without more precise specification, as Day laborer, Farm laborer, Laborer-Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a definite salary), may be entered as House- wife, Housework, or At home, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed or given up on account of the DISEASE CAUSING DEATH, state occupa- tion at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Winthrop

Statement of cause of death .- Name, first, the Disease Causing clerk, as the case may be, a satisfactory written statement containing Death (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Exam- ples: Cerebrospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis"); Diphtheria (avoid use of "Croup"); Typhoid fever (never report "Typhoid pneumonia"); Lobar pneu- monia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, meninges, peritoneum, etc., Carcinoma, Sarcoma, etc., of (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or intercurrent) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 ds. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symp- Shirley Stre tomatic), "Atrophy," "Collapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy," "Exhaustion," "Heart failure," "Hemorrhage," "Inanition," "Marasmus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUERPERAL septicemia," "PUERPERAL peritonitis," etc.

Dr. Abrams.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)

Bronchopneumonia: If primary cause, write the word "primary"; if secondary, give primary cause.

Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, menin- gitis, miscarriage, necrosis, peritonitis, phlebitis, pyemia, septicemia, tetanus.

RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forth- with, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registra- tion a standard certificate of death, stating to the best of his know !- edge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ..... Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall bury or otherwise dispose of a Ahuman body in a town, or remove therefrom a human body which has Onot been buried, until he has received a permit from the board of thealth or its agent appointed to issue such permits, or if there is no "such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, or from one cemetery to another, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be åssued until there shall have been delivered to such board, agent or @the facts required by law to be returned and recorded, which shall be @accompanied, in case of an original interment, by a satisfactory certi- Hficate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be ob- tained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, Hthe medical examiner shall make such certificate. If the death certi- ficate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the 2 United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health or its agent, "upon receipt of such statement and certificate, shall forthwith counter- " sign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as Oto the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., as amended.

Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence .- Gen. Laws, Chap. 38, Sec. 6.

.He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; otherwise a description as full as may be, with the cause and manner of death .- Gen. Laws, Chap. 38, Sec. 7.

No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .- Chap. 114, Sec. 46. G. L., as amended.

305

OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS

The Commonwealth of Massachusetts

Medical Examiner's Certificate of Death (ISSUED UNDER THE PROVISIONS OF GENERAL LAWS, CHAPTER 38)

Boston (City or town)

1 PLACE OF DEATH

County

Suffolk

State

Registered No.

299

(Place of residence)

St.,

Ward

(If death occurred in a hospital or institution, give its NAME instead of street and number)

2 FULL NAME

REBECCA ... BARON

(If in the Army or Navy of the Writer AR gire rank pregaization, etc.)

(a) Residence. No

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

days

How long In U. S., If of toreign birth?

years

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

HARRIS

6 AGE

Years

Months

Days

If less than 1 day ...... hrs. or ...... min.

IF STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

HOUSEWORK

(b) Name of employer

8 BIRTHPLACE (city or town) (State or country)

RUSSIA

9 NAME OF FATHER JACOB PIKE

PARENTS

10 BIRTHPLACE OF FATHER (city or town) (State or country)

RUSSIA

11 MAIDEN NAME OF MOTHER TRINA

12 BIRTHPLACE OF MOTHER (city or town)

(State or country)

RUSSIA

Informant

H ..... BARON

(Address)

214 SHIRLEY ST. WINTHROP

Filed.J.AN ... 13 ,19

Eumylenen

Registrar of city or town where death occurred 4

Registrar of city or town where deceased resided

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

JAN 10, 1928

(Month)

(Day)

(Year)

16 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows : CHRONIC ASTHMA --- DIABETES- -

ARTERIO SCLEROSIS

F.R.AC.TURED.FEMUR --- ACCIDENTAL

FALL

ON FLOOR.

(See reverse side for additional space)

17 Where was injury sustained

if not at place of death ?

(Signed)

TIMOTHY

LEARY M. D.

(Address)

BOSTON

Medical Examiner for SUFFOLK

Bale

JAN. 11, 1928

(Month)

(Day)

(Year)

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

(OHEL JACOB) WOBURN

DATE OF BURIAL

1-11-28

(Month) (Day) (Year)

19 UNDERTAKER MANUEL STANETSKY

ADDRESS

20 Burial permit issued by

Official position.

21 Date of issue

L - -

No.

BOSTON CITYHOSPITAL

City or Town

Boston

214 SHIRLEY

St.,

Ward.

(If non-resident, give city or town and State)

F .

Filed Can. 19, 1928

Rebecca Baron Jan. 10, 1928

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

BOSTON (City or town)

1 PLACE OF DEATH

County

Suffolk

State

Massachusetts

Registered No.

(Place of residence)

City or town

Boston

No.

PETER BENT BRIGHAM HOSPITALSt.,

Ward

(If death occurred in a hospital or institution, give its NAME instead of street and number)

2 FULL NAME

CHARLES CARRO

(If in the Army or Navy of the United States, give rank, organization, etc.)

MASS.

City or Town

WINTHROP

No.

93 CREST AVE.

St.

(a) Residence. State

(Usual place of abode)

Length of residence in city or town where death occurred

years

months

days.

How long in U. S., if of foreign birth?

years

months days

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

4 COLOR OR RACE

5 SINGLE, MARRIED, WIDOWED, OR

DIVORCED (write the word)

5a If married, widowed, or divorced

HUSBAND of

(or) WIFE of

ROSE

6 AGE

Years

Months

Days

If LESS than

1 day, ____ hra.

I STILLBORN, enter that fact here

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

DIAMOND SETTER

(b) Name of employer

8 BIRTHPLACE (city or town) (State or country)

RUSSIA

9 NAME OF

FATHER

MAX CARRO

10 BIRTHPLACE OF

FATHER (city or town)

(State or country)

RUSSIA

11 MAIDEN NAME

OF MOTHER

MINNIE LIFSKITZ

12 BIRTHPLACE OF

MOTHER (city or town)

(State or country)

RUSSIA

Informant

SAMUEL CARRO

(Address)LD SOUTH BLOG. BOSTON,

14 Filed JAN. 18, 19 28 ENMSlenen Filed Jan. 19, 19 18 Registrar of city or town where death occurred

Registrar of city er towe where deceased resided

MEDICAL CERTIFICATE OF DEATH

xxx

(Month)

(Day)

(Year)

I HEREBY CERTIFY, That I attended deceased from

JAN. 13

28 to JAN. 16

that I last saw h.

I Malive on

JAN. 16

and that death occurred, on the dated stated above, at m. The CAUSE OF DEATH was as follows: CHRONIC NEPHRITIS

VALVULAR HYPERTENSION

(duration)

1 yrs.

mos ..

ds.

CONTRIBUTORY

(SECONDARY)

(duration)

yrs ..

.mos.

ds.

17 Where was disease contracted

if not at place of death?

Did an operation precede death ?.

Date of

Was there an autopsy ?.

What test confirmed diagnosis ?.

CLINICAL

(Signed)

LESLIE H. WRIGHT

, M. D.

(Address)

Dale

JAN. 16, 1928

18 PLACE OF BURIAL, CREMATION, OR REMOVAL

(PRIDE OF JACOB) BOSTON

(Cemetery)

(City or town)

DATE OF BURIAL

1-12

, 19 XX

19 UNDERTAKER

MANUEL STANETSKY

ADDRESS

000

15 DATE OF DEATH

JAN. 16, 1928

Exact statement of OCCUPATION is very important. See instructions on back of certificate. PARENTS

Registered No.

467

(Place-of death)

Jan. 16, 1928 (Approved By U. S. Census and American Public Health Association)

Statement of occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. The question applies to each and every person, irre- spective of age. For many occupations a single word or term on the first line will be sufficient, e. g., Farmer or Planter, Physician, Composi- tor, Architect, Locomotive engineer, Civil engineer, Stationary fireman, etc. But in many cases, especially in industrial employments, it is necessary to know (a) the kind of work and also (b) the nature of the business or industry, and therefore an additional line is provided for the latter state- ment; it should be used only when needed. As examples: (a) Spinner, (b) Cotton mill; (a) Salesman, (b) Grocery; (a) Foreman, (b) Automobile factory. The material worked on may form part of the second state- ment. Never return "Laborer," "Foreman," "Manager," "Dealer," etc., without more precise specification, as Day Laborer, Farm Laborer, Laborer-Coal mine, etc. Women at home, who are engaged in the duties of the household only (not paid Housekeepers who receive a defi- nite salary), may be entered as Housewife, Housework, or Athome, and children, not gainfully employed, as At school or At home. Care should be taken to report specifically the occupations of persons engaged in domestic service for wages, as Servant, Cook, Housemaid, etc. If the occupation has been changed of given up on account of the DISEASE CAUSING DEATH, state occupation at beginning of illness. If retired from business, that fact may be indicated thus: Farmer (retired, 6 yrs.). For persons who have no occupation whatever, write None.

Statement of cause of death .- Name, first, the DISEASE CAUSING DEATH (the primary affection with respect to time and causation), using always the same accepted term for the same disease. Examples: Cere- brospinal fever (the only definite synonym is "Epidemic cerebrospinal meningitis") ; Diphtheria (avoid use of "Croup"); Typhoid Fever (never report "Typhoid pneumonia"); Lobar pneumonia; Bronchopneumonia ("Pneumonia," unqualified, is indefinite); Tuberculosis of lungs, men- inges, peritoneum, etc., Carcinoma, Sarcoma, etc., of. . (name origin; "Cancer" is less definite; avoid use of "Tumor" for malignant neoplasms); Measles; Whooping cough; Chronic valvular heart disease; Chronic interstitial nephritis, etc. The contributory (secondary or inter- current) affection need not be stated unless important. Example: Measles (disease causing death), 29 ds .; Bronchopneumonia (secondary), 10 da. Never report mere symptoms or terminal conditions, such as "Asthenia," "Anemia" (merely symptomatic), "Atrophy," "Col- lapse," "Coma," "Convulsions," "Debility" ("Congenital," "Senile," etc.), "Dropsy,""Exhaustion," "Heart failure," "Hemorrhage," "Ina- nition," "Marasmus," "Old age," "Shock," "Uremia," "Weakness," etc., when a definite disease can be ascertained as the cause. Always qualify all diseases resulting from childbirth or miscarriage, as "PUER- PERAL septicemia," "PUERPERAL peritonitis," etc.

State cause for which surgical operation was undertaken.

(Recommendations on statement of cause of death approved by Com- mittee on Nomenclature of the American Medical Association.)

Bronchopneumonia: If primary cause, write the word "pri- mary;" if secondary, give primary cause.

Certificates will be returned for additional information which give any of the following diseases, without explanation, as the sole cause of death: Abortion, cellulitis, childbirth, convulsions, hemorrhage, gangrene, gastritis, erysipelas, meningitis, miscar- riage, necrosis, peritonitis; phlebitis, pyemia, septicemia, tetanus.

FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a stand- ard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the du- ration of his last illness, when last seen alive by the physician or officer and the date of his death ....- Gen. Laws, Chap. 46, Sec. 9.

No undertaker or other person shall bury a human body .. until he has received a permit from the board of health or its agent ... or ... from the clerk of the town where the person died ;. . . No such permit shall be issued until there shall have been delivered to such board, agent or clerk. . . a satisfactory written statement con- taining the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by' a satis- factory certificate of the attending physician, if any. as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insuffi- cient, a physician who is a member of the board of health, or em- ployed by itor by the selectmen for the purpose, shall upon ap- plication make the certificate required of the attending physi- cian. If death is caused by violence, the medical examiner shall make such certificate ... The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Gen. Laws, Chap. 114, Sec. 46.

Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by vio- lence .- Gen. Laws, Chap. 38, Sec. 6.

... He shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if known; other- wise a description as full as may be, with the cause and manner of death. -Gen. Laws, Chap. 38, Sec. 7.

RULES OF PRACTICE

The fulfilment of the purpose of these laws calls for the observance of the following rules of practice:

(1) Attending Physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.

(2) Board of Health Physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.

(3) Medical examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poison), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

R-301

The Commonwealth of Massachusetts

STANDARD CERTIFICATE OF DEATH

Suffolk

State

Massachusetts

Registered No.

City or Town

No.

Community Hosp.

WINTHROP

St Ward

(If death occurred in a hospital or institution, give its NAME instead of street and number) Holzman ..

(If U.S. War Veteran, specify WAR)

(a) Residence. No.

(Usual place of abode)

Length of residence in city or town where death occurred

2 years

months

days. How long in U. S., if of foreign birth? years months days.

PERSONAL AND STATISTICAL PARTICULARS

3 SEX

females

4 COLOR OR RACE

white

5 SINGLE, MARRIED, WIDOWED, OR DIVORCED (write the word) married

5a If married, widowed or divorced

HUODAND of

(or) WIFE of

Benjamin Holzman.

6 AGE

Years

Months

. Days

IF LESS than 1 day ......... hrs. or ........ min.

IF STILLBORN, enter that fact here

also stubborn

(female)

7 OCCUPATION OF DECEASED

(a) Trade, profession, or

particular kind of work

(b) Name of employer

housewife

8 BIRTHPLACE (City)

newark

(State or country)

new Jersey

9 NAME OF

FATHER

William Levy

10 BIRTHPLACE OF

FATHER (City)

new York

(State or country)

ny-

1 1 MAIDEN NAME

OF MOTHER

Harriet Levy

12 BIRTHPLACE OF

MOTHER (City)

(State or country)

ng-

Informant

Benjamin Holz

(Address)

26 0 Braco

14 Jan 18/28 : Filed (Month) (Day) (Year)

REGISTRAR

MEDICAL CERTIFICATE OF DEATH

15 DATE OF DEATH

(Month)

1925

(Day)

(Year)

I HEREBY CERTIFY , That i attended deceased from

Flerember 15, 1927, to.

January 17, 1928

that I last saw

her

alive on

amary 117, 1928

and that death occurred, on the date stated above, at

The CAUSE OF DEATH was as follows: (State fully)

7:30 p.

.m.

Post-partiram hemorrhage

CONTRIBUTORY

(Secondary)

Death of foetus

(duration)

_yrs.

mos ds.

1 7 Where was disease contracted

if not at place of death

Did an operation precede death

yes

betpulsion fetus

Date of operation

January 17/ L gesion delivery

Was there an autopsy

t under one year, was

infant Breast Fed

What test confirmed diagnosis

(Signed) Jacob Draugs

, M. D)

(Address)

1562 Shirley Street, Withup

Date

January 17/1928.

18 PLACE OF BURIAL, CREMATION, OR REMOVAL Rose Hill Centig Elizabeth (Cemetery) (City of town ..

DATE OF BURIAL 1/19/28

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Town of Winthrop : Record of Deaths 1928-1930, Part 3

Author: Winthrop (Mass.) Publication date: 1928 Publisher: Number of Pages: 1296

Author: Winthrop (Mass.)
Publication date: 1928
Publisher:
Number of Pages: 1296