USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 49
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St. (
should be charged sta- tistically.
shoemaker
OCT1015M
R-302
PLACE OF DEATH
SSUETOLK .(County) BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No ....
.6.7.50
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Rose
Schwartz
(If deceased is a married, widowed or divorced woman, give also maiden name.)
140 Cliff Ave
..........
St.
(If nonresident, give city er town and state)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Fem
4 COLOR OR RACE 5 SINGLE
White
(write the word)
MARRIED
WIDOWED
or DIVORCED
widowed
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Jacob ..... Schwantz ..
(Husband's name in full)
6 Age of husband or wife if alive
.years
7 IF STILLBORN, enter that fact here.
8 AGE ... 77 .Years Months. Days
If less than I day Hours Minutes
Usual
9 Occupation:
........ at .... home
Industry 18 or Business:
II Social Security No.
12 BIRTHPLACE (City)
(State or country)
"Russia
13 NAME OF
FATHER
William Nurenberg
14 BIRTHPLACE OF
FATHER (City)
(State of country)
Russia
15 MAIDEN NAME
OF MOTHER
Sophie --
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
Relation, if any
17
Informant.
(Address)
Anna .... Schwartz ( .... dau ..
A TRUE COPY.
25 Mt Hood Ad Brighton
ATTEST:
1
(Registrar of city of town where death occurred)
DATE FILED 8/5/40
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
August 1 1940
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
7/7/40
19
.. ,
to ..
That I attended deceased from
8/7/40
19
...
I last saw h ......... alive
8/1/40
19 ..
.....
death is said
to have occurred on the date stated above, at 1 /4OP
Immediate cause of death.
cerebral .... thrombosis
m.
Duration
24 hrs
Due to .
.arteriosclerosis
12 ... yrs
arterio sclerotic &
hypertensive heart disease
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis?
20 Was disease or lajery in any way related to occupation of deceased ? If so, specify.
(Signed)
O H Wagman
M. D.
(Address)
Winthrop
Date 8/1/40
21 PLACE OF BURIAL.
CREMATION OR REMOVAL ..
City of Boston Woburn
(Cemetery)
(City or Town)
DATE OF BURIAL
Aug 2 1940
19
22 NAME OF
FUNERAL DIRECTOR
M Stanetsky
ADDRESS
Boston
Received and fled. 19
(Registrar of City or Town where deceased resided)
WWW IN Which we deceased resided as soon as possible
50m-10-'39. No. 8427-f after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
No.
126 Kilsyth Rd
(a) Residence. No
......
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
(If U. S.
War Veteran,
specify WAR).
Winthrop
162
Date of.
should be charged sta- tistically.
1
. Tr
I
SEP25KM10
R - 305
of death should be transmitted on Form R-505 to the clerk of the city of town in Which the deceased restdvd 45 8008 85 20551018 after the close of the month in which the death occurred. (Sce Chap. 46, Sec. 12, G. L.)
25m-10-'39. No. 8427-g
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Nova Scotia
(State or country)
15 MAIDEN NAME
OF MOTHER
Phoebe A Andrews
15 BIRTHPLACE OF MOTHER (City) (State or country)
-Virginia
17 Florence A Halsall
Informant (Address) above
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 8/5/40
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH ..
August 1 1940
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY that I have investigated the deat! of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Arteriosclerosis fractured femur
20 Accident, suicide, or homicide (specify) ...... accidents
Date of occurrence.
N.o.v .... 2 .... 1.9.30
19
Where did Injury occur? WinthroRo.MasSt)
Did injury occur in or about the home, on farm, in industrial place, or in public place ? (Specify type of place)
Manner of
Injury
fall from bed.
Nature of Injury
While at work?
Was there an autopsy ?..
no
21 Was disease or lajury in any way related to occupation st deceased?
If so, specify. (Signed) Timothy Leary Boston Date 8/1/19.40
(Address). .
22 Woodlawn Everett
Place of Burial, Cremation or Removal.
(City or Town)
August 4 1940 19
23 NAME OF
FUNERAL DIRECTOR
C R Bennison
ADDRESS Winthrop
Received and Eled. 19
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATH
(County) Boston
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOR
(City or town making return)
Registered No
6763
(If death occurred in a hospital o: institution,
give its NAME instead of street and number)
2 FULL NAME
Mary .....
(1f deceased is a married, widowed or divorced woman, give also maiden name.)
587 Pleasant
........
St. Winthrop
(If nonresident, give city or town and state)
years
months
days.
In this community
yTs.
mos. days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Fem
white
married
Sa Il married, widowed, or divorced
EUSBAND of ..
{Give maiden name of wife in full)
(or) WIFE of
Richard Halsall
(Husband's name in full)
6 Age of husband or wife if alive. 8.6
.Years
7 IF STILLBORN, enter that fact here.
8
AGE 82 Years .....
6. Months. 26Days
Il less than 1 day
Hours
Minutes
Usucl 9 Occupation:
medical doctor
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
East Boston Mass
(State cr country)
13 NAME OF
FATHER
Angus Mc Quarry
Butfolk
(City or Town)
No. NE Hospitalfor Women.& ... Children ..?
Halsall
(a) Residence. No ...
(Usual place of abode)
Length of stay : In hospital or institution.
(If U. S.
War Vateran,
specify WAR)
M. D.
Relation dughterDATE OF BURIAL
SEP 25MIO MM
R-302
Middlesex
(County) Cambridge
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Cambridge
(City or town making return)
Registered No ..
1089
-
No
Holy Ghost Hospital
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
John Thomas Dunn
(lf U. S.
War Veteran,
specify WAR)
164
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
years
months
6
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
(write the word)
single
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
7 IF STILLBORN, enter that fact here.
8 AGE Years Months. Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation:
Retired Meter Reader
Industry 10 or Business:
11 Social Security No ..
Boston
12 BIRTHPLACE (City)
(State or country)
Massachusetts
13 NAME OF
FATHER
Walter S. Dunn
Halifax
14 BIRTHPLACE OF FATHER (City) (State or country)
Nova Scotia
......
15 MAIDEN NAME
OF MOTHER
Jane Flynn
16 BIRTHPLACE OF
MOTHER (City)
Dublin
(State or country)
Ireland
17 Hannah Dunn
Reblog ter
Informant
(Address)
56 Sagamore Avenue, Winthro
A TRUE COPY.
ATTEST:
Frederick H. Burke
(Registrar of city or town where death occurred)
DATE FILED
August
8
.19 ..
40
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
August
7
1.940
(Month)
(Day)
(Year)
19 AUFBEBY CERTIEX. That I attended deceased fra
I last saw h
Ligalive on.
alive on.
August
6
19.
death is said
10:05_A
Duration
Cyst of brain
1932
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or Injury la any way related to occupation of deceased ?
lf so, specify George A ..... Connor,
. M. D.
(Address)
Cambridge
Date
8 7.19 .....
40
21 PLACE OF BURIAL,
CREMATION OR REMOVALY Crosa
(Cemetery)
Malden
(City or Town)
DATE OF BURIAL
August 9
19
40
22 NAME OF
FUNERAL DIRECTOR
John F. O 'Maley
ADDRESS
Winthrop
Received and filed
19
(Registrar of City or Town where deceased resided)
V
any way to town of which the deceased resided as soon as possible
50m-10-'39. No. 8427-f after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
1
PLACE OF DEATH
(If deceased is a married, widowed or divorced woman, give also maiden name.) 56 Sagamore Avenue
x
winthrop
(If nonresident, give city or town and state)
6 Age of husband or wife if alive
to have occurred on the date stated above, at.
Immediate cause of death
19 ....... , to .....
19.
(Signed)
Date of.
should be charged sta- tistically.
City of Boston
حسين
1
EP:231117
-302
PLACE OF DEATH
(County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No ..
6942
(If death occurred in a hospital or institution, Gt. \ give its NAME instead of street and number)
2 FULL NAME
Margaret ......
Greene
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
35 ... Lincoln
.............
.. St.
Winthrop
(If nonresident, give city or town and state)
(Specify whether)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
fem
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
(write the word)
widowed
18 DATE OF
DEATH.
August & 1940
(Month)
(Day)
(Year)
5a If married. widowed, or divorced
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
John P Greene.
(Husband's name in full)
6 Age of husband or wife if alive.
Years
7 IF STILLBORN, enter that fact here.
8 74
AGE Years Months. Days
If less than I day Hours Minutes
Usual
9 Occupation:
at home
Industry
10 or Business:
II Social Security No.
12 BIRTHPLACE (City)
(State or country)
Boston Mäss
13 NAME OF
FATHER
Daniel Sweeney
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Mccarthy
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Informant. John Greene"
Relation, if any son ········ )
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
8/12/40
DATE FILED 19
19
6/3/40
19.
BY CERTIFY.
That I Attended deceased from
I last saw h ......... alive on
8/6/40
19
death is said
to have occurred on the date stated above, at ......
.. P.
m.
Duration
Immediate cause of death ..
carcinoma ... o.f .... r.e.c.t.um
1937
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or Injury in any way related to occupation of deceased ?
(Signed)
M. D.
(Address)
Boston
Date 8/8/40
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Holy Cross
Malden
(Augr12 1940 (City of Town)
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
D J Dooley
ADDRESS
E .... Boston
Received and filed
19
(Registrar ef City or Town where deceased resided)
50m-10-'39. No. 8427-f 0.4% sur Gause of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
1
-
No ......
Elm ... Hill ... Hospital
(If U. S.
War Veteran,
165
(a) Residence. No ......
(Usual place of abode)
Length of stay: In hospital or institution
years
Date of.
should be charged sta- tistically.
If so, specify
J J McHally
(Address)
to ..
8/6/40
19
...
SEP25W9 AM
R-302
PLACE OF DEATH
...
SSUFFOLK (County) BOSTON
(City or Town)
Beth Israel Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOR
(City or town making return)
10686”
....
S (If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME
Bernard
Marcus
(If deceased is a married, widowed or divorced woman, give also maiden name.)
5 Wave Way Ave
.......
.St.
Winthrop Mass
(a) Residence. No ........
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
(If nonresident, give city er town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
(write the word)
single
5a Ii married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
years
7 IF STILLBORN, onter that fact here.
8
AGE 23 Years
Months.
Days
If less than 1 day
.. Hours
Minutes uremia
.y.r.s
Due to
... congestiveheart failure
mo.s.
generalized .... anasarca
meeks
Due to
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
Boston Mass
13 NAME OP
FATHER
Isaac Marcus
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Sarah Schwartz
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17
Informant
(Address)
father
(
A TRUE COPY.
ATTESTI
(Registrar of city or town where death occurred)
DATE FILED 8/16/40
......... 19
18 DATE OF
DEATH.
August 13 1940
(Month)
(Day)
(Year)
19
Y CERTIFY /73740
to.
19
That Lattended deceased from
I last saw h.
im
live on
8/13/40
19 ...
death is said
to have occurred on the date stated above, at 10/25P Duration .m Immediate cause of death. chronic glomerulonephritis yrs
Usual
9 Occupation:
student
Industry
10 or Business:
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
outopsy
Underline the cause to which death should be charged sta- tistically.
28 Was disease or injury in any way related to occupation of deceased ? If so, specify
(Signed)
L .... Rosenfeld
M. D.
(Address).
Boston
Date 8/73/1940
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Workmens Circle Nel-
DATE OP BURIAL
(Cemetery)
Aug 14 1940
19
Fogn's e
22 NAME OF
FUNERAL DIRECTOR
M Stanetsky
ADDRESS
Boston
Received and fled 19
(Registrar of City or Town where deceased resided)
ich tue deccesto resided as soon as possible
50m-10-'39. No. 8427-f after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
Relation, if any
No.
Registered No
(I U. S.
War Veteran,
specify WAR)
19.
....
& Age of husband or wlie if alive
4
. ..
1
3
SEP25KAD AM
-302
PLACE OF DEATH
(County)
BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No. 7100
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Muriel H
Guptill
(If deceased is a married, widowed or divorced woman, give also maiden name.) 120 Loring Rd
.......
.St.
(If nonresident, give city er town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Fem
4 COLOR OR RACE 5 SINGLE
W
MARRIED
WIDOWED
OF DIVORCED
(write the word)
single
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
8 Age of husband or wife if alive.
7 IF STILLBORN, enier that fact here.
8 AGE ..... .2.0.Years Months. .Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
at home
Industry
10 or Business:
Il Social Security No ...
Q17-12-2689
12 BIRTHPLACE (City)
(State or country)
Portsmouth NH.
13 NAME OF
FATHER
Carol Guptill
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Pine Point Me
15 MAIDEN NAME
OF MOTHER
Helen McDonald
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston Mass
17
Informant ........... mother.
(Address)
Relation, if any
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred) 8/17/40
DATE FILED 19
18 DATE OF
DEATH.
August 14 1940
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
8/13/40
19
That I attended deceased from
I last saw h ............ alive on.
8/40
19 ........ , death is said
Immediate, cause of death.
toxic hepatitis
Due to
?
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis ?.
should be charged stx- tistically.
20 Was dissase or lajury In any way related to occupation of deceased ? If so, specify
(Signed)
W.B.Osgood
M. D.
(Address).
Boston
Dat 3/74/1940
21 PLACE OF BURIAL,
CREMATION OR REMOVAL.
Holy Cross
Malden
DATE OF BURIAL
(Cemetery)
Aug 17 1940
19
22 NAME OF
FUNERAL DIRECTOR
D J Dooley
ADDRESS
E .... B.o.s.t.o.n
Received and Blod. 19
(Registrar of City or Town where deceased resided)
50m-10-'39. No. 8427-f Bist we trust of die moatt in Which the death occurred. (See Chap. 46, Sec. 12. G. L.) PARENTS
No. Peter Bent Brigham Hospital
5
St. l
(If U. S.
War Veteran,
specify WAR)
Winthrop
(a) Residence. No ......
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
years
to have occurred on the date stated above, at 2/20A n. Duration 14 dys
...
(City or Town)
Date of
to ..
8/14740
19
1
1
SEP 2 5M 3 AM
-302
after the close of the month in which the death oscurred. (See Chap. 46, Sec. 12, G. L.)
50m-10-'39. No. 8427-f
PLACE OF DEATH
(County) . BOSTON (City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTAN
(City or town making return)
Registered No
7142
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
169
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
61 Court Rd
......
.St.
(If nonresident, give city er town and state)
....
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
fem
4 COLOR OR RACE| 5 SINGLE
MARRIED
white
WIDOWED
or DIVORCED
(write the word)
widowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Frank ..... J ..... Leach
(Husband's name in full)
years
8 Age of husband or wife if alive.
7 IF STILLBORN, onier thal faci here.
8
AGE 54 Years.
.Months.
Days
If less than 1 day
.Hours
.Minules
Usual
9 Occupation:
at home
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
E.Boston .... Mass
(State or country)
13 NAME OF
FATHER
William J Burke
14 BIRTHPLACE OF
FATHER (City)
New Brunswick
(State or country)
15 MAIDEN NAME
OF MOTHER
Margaret F Ryan
16 BIRTHPLACE OF
MOTHER (City)
Cork Ireland
(State or country)
17 Alice D Burke
Relation, if any
sister
(Address)
26 Enfield Rd Win
A TRUE COPY.
ATTESTI
(Registrar of city or town where death occurred)
DATE FILED 8/19/40-
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Aug 15 1940
(Month)
(Day)
(Year)
19 | HERE 8714/48 19 ..... , to.
CERTIFY.
That I attended deceased from
8715/40
19
...
I last saw h ....... alive on. 8/15/40, 19, death is said to have occurred on the date stated above, at 3/15Am Duration Immediate cause of death .. carcinoma ... of ..... sigmoid
indef
partial ..... obstruction ... large
Due lo .ho.we.l.
.perforation .... o.f .... bowel .... with
Due to secondary peritonitis & abscesse.s.
1 ... mg.
Other conditions
..
diabetes mellitus
II mos PHYSICIAN
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Dale of.
Of autopsy
What test confirmed diagnosis ?.
28 Was disease or Injory In any way related to occupation of deceased ? If so, specify Marble
(Signed)
M. D.
(Address) ... Boston
Date.
8/15/19 40
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
St Paul's
Arlington
DATE OF BURIAL
Aug 17 1940
19
22 NAME OF
FUNERAL DIRECTOR
M J Kelly
ADDRESS
Boston
Received and Blod. 19
(Registrar of City or Town where deceased resided)
PARENTS
Informanl.
No. Palmer Memorial Hospital
Gertrude A
St. Í
Leach
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
Winthrop
wks
Underline the cause to which death should be charged sta- tistically.
(Cemetery)
(City or Town)
٢٠٠
SEP 25143 AH
302
after the close of the month in which the death occurred. (See Cbap. 46, Sec. 12. G. L.)
50m-10-'39. No. 8427-f
uffous
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No .....
.7.3.52
(If death occurred in a hospital or institution,
St. l give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
50 Cutler
.St.
Winthrop
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
(write the word)
widowed
5a If married, widowed, or divorced
HUSBAND of
Anna Mankawitz
(or) WIFE of
(Husband's name in full)
years
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
69
AGE
Years
Months.
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
tailor
Industry
10 or Business:
Il Social Security No.
12 BIRTHPLACE (City)
(State or country)
Austria
13 NAME OF
FATHER
Max Housman
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Austria
15 MAIDEN NAME
OF MOTHER
Ida-
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Austria
.........
17
Max Housman
..
Relation if any
Informant
(Address)
A TRUE COPY.
ATTEST:
James Q. Burke
(Registrar of city or town where death occurred)
DATE FILED 19
8/27/40
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Aug 24 1940
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
8/11/40
19.
..... , to ...
8/24/40
19 ..
That I attended deceased from
I last saw h .... i.m.alive on.
8/24/40, 19, death is said
to have occurred on the date stated above, at ... 10./.25m.
Immediate cause of death ..
Daration
broncho .... nneumonia
5 dys
4
-
.... y.r.s. .....
... congestive ... heart ... failure
1 ..... wk.
13 dys
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Date of ..
Of autopsy
What test confirmed diagnosis?
28 Was disease or Injury in any way related to occupation of deceased ?
If so, specify
(Signed)
B ... Gline. Jr.
M. D.
(Address)
Boston
Date/24/1940
21 PLACE OF BURIAL.
CREMATION OR REMOVAL.
.Austrian
W ..... Rox
DATE OF BURIAL
July 25 1940
19
22 NAME OF
FUNERAL DIRECTOR
JH Levine
ADDRESS
Boston
Received and filed. 19
(Registrar of City or Town where deceased resided)
1
PLACE OF DEATH
(County)
Boston
(City or Town)
No. 330 Brookline Ave
Harris
Housman
(If U. S.
War Veteran,
specify WAR)
169
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
.......
PARENTS
Due to ..... bronchial .... asthma
Due to ..... perforated .... appendix. with peritonitis
Underline the cause to which death should be charged sta- tistically.
(Cemetery)
(City or Town)
1
-
1
SEP 2510 0 MM
-302
1
PLACE OF DEATH
(County)
BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No
7523
(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME
Paul Temple
Robbs
(If deceased is a married, widowed or divorced woman, give also maiden name.)
3.3.5 ... Winthrop
.....
St.
Winthrop
(If nonresident, give city or town and state)
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
M
4 COLOR OR RACE 5 SINGLE
MARRIED
W
WIDOWED
or DIVORCED
(write the word)
married
5a If married, widowed, or divorced
HUSBAND of
.Anna .... A ..... ConJe.v ..
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
50
years
7 IF STILLBORN, enter that fact here.
8 ÅGE ... .. 49 .. Years. .... ] .. ] .... Months ...... ].Days
If less than 1 day Hours Minutes
Usual
9 Occupation:
glass cutter
Industry 18 or Business:
11 Social Security No .......
011-03-1914
12 BIRTHPLACE (City)
(State or country)
Boston Mass
13 NAME OF
FATHER
Willard R Robbs
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
15 MAIDEN NAME
OF MOTHER
Clara E Temple
16 BIRTHPLACE OF
MOTHER (City)
"Bowdoinham Me"
(State or country)
17
Informant.
(Address)
wife
Relation, if any
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 9/4/40
........ ....... 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
August 31 1940
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
8/26/40
19
8/31/40
That I attended deceased from
to ..
19
....
I last saw h ........... alive on
8/31/40
19 ..
, death is said
to have occurred on the date stated above, at ..
4/10A
.... m.
Duration
Immediate cause of death.
acute appendicitis
16 dys
acute purulent pylephlebitis-& dys
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
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