Town of Winthrop : Record of Deaths 1938, Part 40

Author: Winthrop (Mass.)
Publication date: 1938
Publisher:
Number of Pages: 522


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1938 > Part 40


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.... 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 hody 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 huried 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 madc. . . .- CHAP. 114, SEC. 46, G. L. (TERCENTENARY EDITION.)


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the ob- servance 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 clirectly or indirectly by traumatism (including resulting septi- cemia), and by the action of chemical (drugs or poisons). 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.


.


MR-302


Middlesex


(County) Cambridge


(City or Town) No ... Holy .... Ghost .... Hos.pi.tal


.St.,


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


Mambridge


(City or town making return)


Registered No


653


(If death occurred in a hospital or institution,


.Ward


give its NAME instead of street and number)


2 FULL NAME


Edward Keenan


(If deceased is a married, widowed or divorced woman, give also maiden name.)


11 Locust St.


.St., .............


Ward,


(If nonresident, give city or town and state)


Length of residence in city or town where death occurred


yrs.


mos.


days.


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


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Ma.y ..... 17


1938


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


May 1


1938., to ..


May 17


1938.


I last saw h.


alive on


im


May 16


38


to have occurred on the date stated above, at


.m.


The principal canse of death and related Buse lof Anportance in order of onset were as follows:


Dateofonset


Arterio Sclerosis


about


1930


Contributory causes of importance not related to principal cause:


Name of operation


Date of


What test confirmed diagnosis?


Was there an autopsy ?.


20 Was disease or injury in any way related to occupation of deceased? .... ]


If so, specify


M. D.


(Signed) ..... Daniel Mac Killop


(Address)


Cambridge


5/17


38


21 PLACE OF BURIAL


CREMAGOULOT REM:08.8 .Gem. .. Malden city or town)


(Cemetery)


19


22 NAME OF


UNDERTAKER


R .... Kirby


ADDRESS


Fast Roston


MATr 10 1020


Received and filed


19


NR.


ATTEST:


May 19 1938


(Registrar of city or town where death occurred)


DATE FILED Frederick It. Burke


19


....


50m-9-31. No. 3385-g


1


(a) Residence.


No.


(Usual place of abode)


3 SEX


4 COLOR OR RACE


M


.


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


7


AGE


88


Years


Months


Days


8 Trade, profession, or particular


kind of work done, as spinner,


sawyer, bookkeeper, etc ...


9 Industry or business in which


work was done, as silk mill,


saw mill, bank, etc .....


10 Date deceased last worked at


this occupation (month and


OCCUPATION


year)


12 BIRTHPLACE (City)


Dublin


13 NAME OF


FATHER


John Keenan


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


16 BIRTHPLACE OF


PARENTS


MOTHER (City)


(State or country)


Ireland


17


Mra Jos Fldridge


A TRUE COPY.


WDITE PI AINI Y WITH LINFADING INK- THIS IS A PERMANENT RECORD. Every item of informa-


OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very


(State or country)


Ireland


important.


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Widowed


5a If married, widowed, or divorced


HUSBAND of


Sarah.Deacey


(Give maiden nanse of wife in full)


If less than 1 day


.Hours Minutes


Sail Maker


Ship yard


11 Total time (years)


spent in this


occupation.


15 MAIDEN NAME


OF MOTHER


Bridget Connolly


Informant


(Address) 11 Locust St. Winthrop


daughter


DATE OF BURIAL


May .. 19


1988


Date


19


(Registrar of City or Town where deceased resided)


PLACE OF DEATH


(If U. S.


War Veteran,


specify WAR)


inthrop


death is said


FBO1A


JIMTION are very


1


PLACE OF DEATH


SUFFOLK (County) WINTHROP , MASS.


(City or Town)


WINTHROP COMMUNITY HOSPITAL. No.


The Commonwealth of Alassachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


To be filed for burial permit with Board of Health or its Agent.


Registered No.


98


f (If death occurred in a hospital or institution,


St., .. Ward ( give its NAME' instead of street and number)


2 FULL NAME


BABY MALE KEARNEY.


(If deceased is a married, widowed or divorced woman, give also maiden name.)


specify WAR)


25 GORDON


ROAD,


LYNN . .


St.,


Ward,


(If nonresident, give city or town and state)


Length of residence in city or town wbere death occurred


years


months


days.


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


years


months


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


MALE


4 COLOR OR RACE


WHITE


5 SINGLE


(write the word)


MARRIED


WIDOWED


OF DIVORCED


SINGLE


6a If married, widowed, or divorced HUSBAND of


(or) WIFE of


(Give maiden name of wife in full)


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


STILLBORN.


If less than 1 day


Hours .. Minutes


OCCUPATION


9 Industry or business in which work was done, as silk mill, saw mill, bank, etc ...


10 Date deceased last worked at


11 Total time (years)


spent in this


occupation.


12 BIRTHPLACE (City).


WINTHROP , MASS.


(State or country)


13 NAME OF


FATHER


FREDERICK KEARNEY.


14 BIRTHPLACE OF


FATHER (City)


BOSTON , MASS.


(State or country)


15 MAIDEN NAME


OF MOTHER


MARGARET CURTIN.


16 BIRTHPLACE OF MOTHER (City) (State or country)


BOSTON , MASS.


(Address)


19 Piment-Sr 23 Date 5/19


.19:3.8.


GARDEN.


CHELSEA , MASS.]


21.


Place of Burial,


Removal.


(City or Town)


38


Informant


(Address)


25 GORDON ROAD, LYNN , MASS.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


mielía 2. Children


(Signature of Agent of Board of Health or other) agent may 20/38


(Official DesignAtion) (Date of Issue of Permi


18 DATE OF


DEATH


way


19,1938


(Year)


(Month)


(Day)


That I attended deceased from


May 19


I HEREBY


DERTIF


1000


to


thay 19


1938


,


I last saw h ..... allve on ludy 19 1938 death Is sald to have occurred on the date stated above, at ... 3 .... m. The principal cause of death and related causes of Importance In order of onset were as follows: Data of Onset IMPORTANT Still Losu


Contributory causes of Importance not related to principal cause: Transmise position with contracted pellico. Version.


Name of operation


What test confirmed diagnosis?


Was there an autopsy ?.


20 Was disease or Injury in any way related to occupation of deceased?


If so, specify.


Frozen. It. Schwartz


(Signed)


M. D.


22 NAME OF


William 9: Treanor


UNDERTAKER


559 SARATOGA STREET E.B. MASS.


ADDRESS


Received and filed. MAY 2-6-192


19


(Registrar)


1001-12 '35. No. 6156F


PHYSICIANS bould stata CALISE OF DEATH


important. See instructions and extracts from the laws on back of certificate.


17 FREDERICK KEARNEY.


FATHER!


DATE OF BURIAL


MAY 20


Date of.


5/9/38


PARENTS


this occupation (month and


year)


7


AGE


Years


.Months.


.Days


8 Trade, profession, or particular


kindofwork done, as spinner,


sawyer, bookkeeper, etc ...


(If U. S.


War Veteran


(a) Residence.


No.


(Usual place of abode)


Statement of occupation. - Precise statement of occupation is- very important, so that the relative healthfulness of various pur- suits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the occupation prior to illness. If the deceased had retired from bus- iness, report the occupation prior to retirement. Children not gainfully employed may be returned as AT SCHOOL Or AT HOME. For a woman whose only occupation was that of home housework, write HOUSEWORK in answer to Question 8 and OWN HOME in answer to Question 9. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as HOUSEKEEPER-PRIVATE FAMILY, COOK-HOTEL, etc. For a person who had no occupation whatever write NONE.


To be complete, an occupation return must state :


8 .- The trade, profession, or particular kind of work done.


9 .- The industry or business in which the work was done.


10 .- The month and year the deceased last worked at the occupation.


11 .- The number of years the deceased followed the occupation.


In stating the occupation, avoid the use of such indefinite terms as "employee," "worker," "operative," etc. Find out the partic- ular kind of work done and return that, as SPINNER, WEAVER, etc.


In stating the industry or business, avoid the use of such gen- eral ternis as "store," "factory," "mill," etc, State the particular kind of store, factory, mill, etc., as GROCERY STORE, SOAP FACTORY, COTTON MILL, etc.


Distinguish carefully the different kinds of engineers by stating the full descriptive titles, as CIVIL ENGINEER, MECHANICAL ENGIN- EER, MINING ENGINEER, STATIONARY ENGINEER, etc. Avoid the term "laborer" when a more precise statement of the occupation can be secured. Do not use the word "mechanic," but give the exact occupation, as CARPENTER, PAINTER, MACHINIST, etc. Distinguish carefully between RETAIL MERCHANTS AND WHOLESALE MERCHANTS. A person who sells goods should be called a SALESMAN and not a CLERK.


Statement of Cause of Death. - Cause of death means the disease, or complication which causes death, NOT the mode of dying, E. G., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death .. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause. Under contributory causes of importance not related to principal cause, name other important diseases.


Example.


The principal cause of death and related causes of importance in order of onset were as follows:


Dste of Onset


Arteriosclerosis


1915


Chronic interstitial nepbritis


1921


Cerebral hemorrhage


July 5, 1927


Contributory causes of importance not related to principal cause :


In a group of causes containing the principal cause and related causes, the causes should be given in the order of onset, so that in a group of three causes the principal cause may appear in either first, second, or third position. The principal cause in the above example happens to be the second cause given.


with, alter 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 standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his sup- posed 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 human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit 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 person · died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, 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 issued until there shall have been delivered to such board, agent or clerk, as the case may be, 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 satisfactory certificate of the attending physician, if any, as re- quired by law, or in lieu thereof a certificate as hereinafter pro- vided. If there is no attending physician, or if, for sufficient rea- sons, his certificate cannot be obtained early enough for the pur- pose, or is insufficient, a physician who is a member of the hoard of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attend- ing physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was re- moved within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate 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 United States in any war in which it has been engaged, such recital shall ap- pear 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 cer- tifying 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 .- CHAP. 114, SEC. 45,, G. L. (TER- CENTENARY EDITION.)


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. (TERCENTENARY EDITION.)


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the ob- servance 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 septi- cemia), and by the action of chemical (drugs or poisons), 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.


KN R-302


PLACE OF DEATH


(County)


(City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


(City or town making return)


Registered No.


99


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


St.,


Ward


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a)


Residence. No.


(Usual place of abode)


Length of residence in city or town where death occurred


yrs.


St.,.


. Ward,


(If nonresident, give city or town and state)


mos. days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


ny 10 2050


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


33


19 ..


* }:, to.


,19 ..


I last saw h ....... Calive on


19.


death is said


to have occurred on the date stated above, af ...... O.m. The principal cause of death and related causes of importance In order of onset were as follows:


Dateofonset


Contime :1 boule


Naturel a mediatic


2 .... 13?


Contributory causes of importance not related to principal cause:


Name of operation


Date of.r.Y?


What test confirmed dlagnosis?


Was there an autopsy ?........


20 Was disease or injury in any way related to occupation of deceased?


If so, specify.


(Signed)


., M. D.


(Address)


Date ..


5/219 33


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


(Cemetery),


(City or town)


DATE OF BURIAL


19.


22 NAME OF


UNDERTAKER


ADDRESS


Received and filed


Imay 19


38


19


111


DATE FILED


June


.. 19 38 .....


7-


A TRUE COPY. 1


ATTEST:


(Registrar of city or town where death occurred)


2


important.


50m-9-31. No. 3.3.8 ª_₪


1 No. 2 FULL NAME 3 SEX ... (or) WIFE of 7 Frau itam of infrom OCCUPATIONI 13 NAME OF FATHER 15 MAIDEN NAME OF MOTHER PARENTS 17 Informant (Address) Lon snui ve caresuny Suppucu. W/DITE DI AINI V WITH LINFANING INK.THIS IS A PERMANENT RECORD OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very (State or country)


4 COLOR OR RACE


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


5a If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


AGE ... Years .Months ...... Days


If less than 1 day .. Hours ...... Minutes


8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc. 150


9 Industry or business in which work was done, as silk mill, saw mill, bank, etc.


10 Date deceased last worked at


11 Total time (years)


spent in this


occupation


this occupation (month and


year)


12 BIRTHPLACE (City)


14 BIRTHPLACE OF FATHER (City)


(State or country)


16 BIRTHPLACE OF MOTHER (City) (State or country)


mos.


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


yrs.


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


(Registrar of City or Town where deceased residen)


..


...... .....


MR-302


SUFFOLK


-(County)


BOSTUY


(City or Town)


No Boston City Hosp


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


BOSTON. (City or town making return)


Registered No


.4391 100


(If death occurred in a hospital or institution,


give its NAME instead of street and number)


Rose Cohon


2 FULL NAME


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a)


Residence.


No


(Usual place of abode)


38 ... Trident .. Av.


.St.,.


Ward,


Winthrop


(If nonresident, give city or town and state)


Length of residence in city or town where death occurred


yrs.


mos.


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


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


DEATH


Larr


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from


5/20/38


,19


to


5/01/38


., 19.


[ last saw h


.. alive on ..


19


death is said


XXX XXXXXXXXXXXXX to have occurred on the date stated above, at. m.


The principal cause of death and related causes of importance in order of onset were as follows:


... arachnoidal fibroblastoma of ..


brain


mos.


Contributory causes of importance not related to principal cause:


cerebral odeme


Name dropegatina logram


Date of ....


5/20/38


What test confirmed diagnosis?


Was there an autopsy


yes


20 Was disease or injury in any way related to occupation of deceased?


If so, specify.


(Signed)


uw O'Connell


(Address)


Boston City Losp


Date


5/21


19


21 PLACE OF BURIAL,


CREMATION OR REMOVALMese:1 .... Igrapl


(Cemetery)


(City of town)


DATE OF BURIAL


4/00/00


19


22 NAME OF


UNDERTAKER


Stanetsky


ADDRESS


Boston


Received and filed


JUN 1 1 1938


19


(Registrar of City or Town where deceased resided)


important.


A TRUE COPY.


ATTEST:


James Q. Burke


DATE FILED


(Registrar of city or town where death occurred)


5/24/38


19


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


May 21/38


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


Jacob Cohen


(or) WIFE of


(Husband's name in full)


6 IF STILLBORN, enter that fact here.


AGE


Years Months Days


If less than 1 day Hours .Minutes


OCCUPATIONI


8 Trade, profession, or particular kind of work done, as spinner, sawyer, bookkeeper, etc.


housewife


9 Industry or business in which


work was done, as silk mill,


saw mill, bank, etc ...


at home


10 Date deceased last worked at


this occupation (month and


year)


1 1 Total time (years)


spent in this


occupation.


12 BIRTHPLACE (City)


(State or country)


Russia


13 NAME OF


FATHER


Isasc Lurensky


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country) Russia


15 MAIDEN NAME


OF MOTHER


Annie ---


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Russia


17 Norris


Informant


(Address)


son


50m-9-'31. No. 3385-₪


N. B .- WRITE PLAINLY. WITH UNFADING INK- THIS IS A PERMANENT RECORD. Every item of informa- OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very


1


PLACE OF DEATH


St.,


.......... Ward


(If U. S.


War Veteran,


specify WAR)


M. D.


Toburn.


Dateofonset


7


54


M ?- 301 À


WRITE PIAINI.Y. WITH UINFADING BLACK INK THIS IS A PERMANENT RECORD. See instructions and extracts from the laws on back of certificate.


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION


is very important.


75m-5-'32. No. 5469


I HEREBY CERTIFY, that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wim. D. Childrens (Signature of Agent of Board of Health or other)


Health Officer 5/22/38


(Official Designation)


(Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


may 22 - 1938


(Month)


(Day)


(Year)


19. I HEREBY CERTIFY, That I attended deceased from


May 8


1938 to.


may 22


1938


I last saw her alive on


may


2/


, 1938, death is said


to have occurred on the date stated above, at. 9 a.m.


The principal cause of death and related causes of importance in order of onset were as follows:


Date of Onset IMPORTANT


may 221938


Contributory causes of importance not related to principal cause: Fibraid uterus


may 1938


Name of operation


Paulinaterectomy


What test confirmed diagnosis?,


Was there an autopsy? no no


20 Was disease or injury in any way related to occupation of deceased?


If so, specify.


M. D.


Charles Melon


(Signed)


(Address) 905 Havre S DBisty Date May2 70-1938


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Il Vareicius Framingham


DATE OF BURIAL


May


(Cemetery)


25


(City or town) ml 193.8 ..


22 NAME OF


Manchino Hollander


UNDERTAKER


ADDRESS


122 Hollis St. Framingham


Received and filed 19


MAY 26 1938


(Registrar)


1


PLACE OF DEATH


(County) Winthrop


(City of Town)


Winthrop Community Hospital


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


To be filed for burial permit with Board of Health or its Agent.


Registered No ..... 0.1.


(If death occurred in a hospital or institution,


Ward give its NAME instead of street and number)


2 FULL NAME


Sala Descope


(If deceased is a married, widowed or divorced woman, giye also maiden name.)


44Bridges It Spannings011


Ward,


(If nonresident, give city or town and state)


mos. days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


Female While


5 SINGLE


(write the word)




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