USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 40
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Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; . . . - General 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 he, with the cause and manner of death. -General Laws, Chap. 38, Sec. 7.
. . The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment 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 hy 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 ail deaths supposably due to injury. These include not only deaths caused directly or Indirectly by traumatism (including resulting septicemia), and hy 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.
STATEMENT OF CAUSE OF DEATH
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause, the nature of an injury and of its consequences; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with asso- ciated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumable nature; and (2) under manner, indicate the cir- cumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the brain (basal ganglia) (found dcad in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person).
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
M R-302
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time
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
ROSTON (City dr town making return)
5584 . R
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
79 Locust
Winthrop Mass
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ..
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
male
4 COLOR OR RACE 5 SINGLE
MARRIED
white
WIDOWED
or DIVORCED Widowed
(write the word)
18 DATE OF
DEATH.
June 30 1942
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
6/29/42
19.
.... , to ...
61.30 42
That I attended deceased from
19 ......
I last saw h .. 1m ... alive on.
6/30/42
19
death is said
to have occurred on the date stated above, at 3 A .m.
Duration
8 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact boro.
AGE
8 79 Years Months. Days
If less than 1 day
Hours .....
Minutes
Usual
9 Occupation:
Hebrew teacher
Industry 10 or Business:
11 Social Security No ..
Russia
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Morris I Gadon
14 BIRTHPLACE OF
R (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
--
16 BIRTHPLACE OF
MOTHER (City)
Russia
(State or country)
17
Informant.
Sydney Gadon
Relation, if any son ....... )
A TRUE COPY.
ATTESTI
francis
(Registrar of Sty or town where death ofcurred)
DATE FILED
7/2/42
19
Due to
Due to
Other conditions
heart dis. (rheumatic
(Include pregnancy within 3 months of death)
hypertensiv.e.).
Major findings :
Of operations
Date of.
PHYSICIAN 20-yrs Underline the cause to which death should be charged sta- tistically.
What test confirmed diagnosis ?.
20 Was disease or Isjury In any way related to occupation of deceased ? If so, specify
(Signed)
S M Levenson
Boston
M. D.
(Address)
Dat
6/30/19
42
21 PLACE OF BURIAL,
CREMATION OR REMOVALBeth Israel N Reading
(Cemetery)
ity or Town)
June 30 1942
19
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
M Schwartz
ADDRESS
Malden
Received and fled 19
JUL 3 1942
(Registrar of City or Town where deceased resided)
50m-10-'39. No. 8427-f
Suffolk
No ........
Beth ... Israel .... Hospital
...........
St.
David
Gadon
(II U. S.
War Veteran,
specify WAR)
(If nonresident, give city or town and state)
(Specify whether)
Sa If married, widowed, or divorced HUSBAND of
Fanny .... S ... Greenberg ..
(Give maiden name of wife in fuil
(or) WIFE of
(Husband's name in full)
.years
Immediate cause of death ... gep.ti.c ... & .... non"." vascular .... collapse
mesenteric .... thrombosis
1/2 dy 1.2 .... dys
Of autopsy
PARENTS
(Address)
8
Registered No.
M R-305
PLACE OF DEATH
Suffolk (County)
Revere. (City or Town) Belle Isle Creek No.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
REVERE 179 (City or town making return)
Registered No.
174
1 (If death occurred in a hospital or institution, S :. ( give its NAME instead of street and number)
2 FULL NAME
Carmine Brenna
(If deceased is a married, widowed or divorced woman, give also maiden name.)
14 Bank
..........
months
days.
(If nonresident, give city or town and state)
In this community
yrs.
mos.
1
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE 5 SINGLE
(write the word)
MARRIED
Married
Se Il married, widowed i difined Sabia HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
421
Years
AGE 46 Years ..... ..... Months ........... Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Restaurant Owner
For Himself
15 MAIDEN NAME
OF MOTHER Cannot be Learned)
17 Filomena Brenna
Winthroy
A TRUE COPY.
ATTEST:
1
Registar of city of town where death ochuvedo
DATE FILED
June 15, 19.42
MEDICAL CERTIFICATE OF DEATH
13 DATE OF DEATH June
7. 1942
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows : (If an injury was involved, state fully.) Drowning, Matter not known
Old Cerebral Hemorrhages.
20 Accident, suicide, or homicide (specify)
Date of occurrence.
June 7,
.19 ..
42
Where did
Injury occur?
Revere
(City or town and State)
Did injury occur in or about the home, on farm, in industrial place, or in
public place ?
(Specify type of place)
Manner
Injury
Found dead in Belle Isle
Nature of
Creek on June 7, 1942
injury
While at work?
No
Was there an autopsy?
Yes
21 Was disease er injury la any way related to occupation of deceased ?
I! so, specify
(Signed).W.m. J. Brickley
(Address) Boston , Mass.
M. D.
St. Michael
Boston
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
June 11
19
23 NAME OF FUNERAL DIRECTOR Joseph A. Langone, Jr.
ADDRESS
190 North St. ,Boston, Lass.
Received and filed TIL 1 4 1942
19
(Registrar of City or Town where deceased resided)
(If U. S. War Veteran. specify WAR)
St.
Winthrop
(a) Residence. No .....
(Usual place of abode)
None
Length of stay: In hospital or institution
(Specify whether)
years
- 3 SEX Male White (or) WIFE of 6 Age of husband or wife if alive 7 IF STILLBORN, ealer that fact here. 8 Industry 10 or Business: 11 Social Security No. None 12 BIRTHPLACE (City) (State or country) Italy FATHER 14 BIRTHPLACE OF FATHER (City) (State or country) Italy PARENTS 16 BIRTHPLACE OF MOTHER (City) of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible 25m-10-'39. No. 8427-g Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time - (State or country) Italy after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
1
13 NAME OF
Arcangelo Brenna
Relation of any (Address) 14 Banks St., REXEXE,
Date 6/8/19 42
42
WIDOWED
or DIVORCED
-
RM R-302
Essex
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Danvers
(City or town making return)
1
PLACE OF DEATH
(County)
Danvers
(City or Town)
No. Danvers ... State .... Hospital Clara J. Paine
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
125 Cliff Ave.
Winthrop
(a) Residenoe. No.
St.
(If nonresident, give city or town and State)
Length of stay : In hospital or institution.
(Before death)
(Specify whether)
years
7
months
Pays.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
female
4 COLOR OR RACE|
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
Oct.
2.3,19 .41,
to .... Tune.
1.8 .. , .... , 19 ... 42.
I last saw h
@ Talive on.
Tune9 .18 geatnl 2 sald to
(or) WIFE of
(Husband's name in full)
have occurred on the date stated above, at.L ... 30/
m.
Duration
Immediate cause of death
Generalized arteriosclerisis
4 yrs
Chronic myocarditis
1 vr
Terminal Bronchopneumonia
7 days
Due to ..
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations.
Date of
should be
charged sta-
Of autopsy
clinical
tistically.
What test confirmed diagnosis?
20 Was disease or injury in any way related to oooupation of deceased ?... ILQ.
If so, specify
Myer Asekoff
(Signed)
DSH
6/19 4M. D.
Date ...
21 PLACE OF BURIALWinthrop
Winthrop
DATE OF BURIAL
22 NAME OF
Charles R. Bennison
FUNERAL DIRECTOR
ADDRESS
Winthrop
Received and filed.
6/30/42
.19
JUL 13 4
...... 442
(Registrar of City or Town where deceased resided)
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
N.H.
15 MAIDEN NAME
OF MOTHER
Mary Tewksbury
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Winthrop
17 M.K. McPhillips
Relation, if any
Informant.
(Address)
A TRUE COPY.
ATTEST :
Questa Chant
(Registrar of city or town where death occurred)
DATE FILED
6/20/42
19
18 DATE OF
DEATH
June 18, 1942
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
75 Years
Months Days
If less than 1 day
.Hours.
Minutes
Usual
9 Occupationnet. Prop. Dry Goods Store
Industry 10 or Business :
Il Social Security No ..
cannot be learned
12 BIRTHPLACE (City)
Winthrop
(State or country )
13 NAME OF
FATHER
Benjamin Paine
Meredith
Underline
the cause to
which death
(Address)
CREMATION OR REMOVAL
(Cemetery)6/20/42 (City or Town)
19
50m (e)-1-41-4667
5
( If death occurred in a hospital or institution,
St.
( give its NAME instead of street and number)
Registered No.
120
(If U. S.
War Veteran,
specify WAR)
(Usual place of abode)
That I attended deceased from
AGE
JUL 1 :1 1342 F ..
1 R-301 A
Suffolk
(County)
Winthrop (City or Town)
No.
62 Chester Ave.
The Commontoralth 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.
121
[ {If death occurred in a hospital nr Institutinn, St. ¿ give its NAME instead of street and number )
2 FULL NAME
Marvin Ross Moran
(If deceased is a married, widowed or divorced woman, give also maiden name.) 62 Chester Ave.
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
days.
In this community 33 yrs. mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
White
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Married
5a If married, widowed, or divorcedrion Lane
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Thusband's name In full)
6 Age of husband or wife if alive 55
years
7 IF STILLBORN. enter that fact here.
AGE
64
Years
8
Months
28 Days
If less than 1 day
Hours ......
Minutes
Usual
9 Occupation :
Production Manager
Industry
10 or Business :
Cofffe
11 Social Security No.
010-07-4793
Derby Line
12 BIRTHPLACE (City)
(Slate or country)
Vermont
13 NAME OF
FATHER
Marvin Moran
14 BIRTHPLACE OF
FATHER (City)
Derby
(State or country)
Vermont
15 MAIDEN NAME
OF MOTHER
Mae Spear
16 BIRTHPLACE OF
MOTHER (City)
Windsor
(State or country)
Vermont
17 Marion Moran
Relation, if any
Informant
( Address)
62 Chester Ave. Winthrop
I HEREBY CERTIFY that a satisfactory, standard certificate of death was filed with me BEFORE the burlal'or transit permit was Issued : Childrensx
(Signature of Agent of Board of Health of other)
Health Officer 7/4/42
(Official Designation) (Date of Issue of Permity
18 DATE OF
DEATH
July
2
1942
(Month)
(Das)
(Year)
19 I HEREBY CERTIFY,
That I attended deceased from
19
to
19
I last saw h ...
......
alive on
19
death Is sald to
have occurred on the date stated above, at
2
.m.
Duration IMPORTANT
Immediate cause of death Natural causes
Due to.
Probable coronans occlusion 18hrs
Due to.
Other conditions
(Include preguancy within 3 months of death)
IMPORTANT
Physician
Major findings :
Of operations
Date of
Of autopsy
What test confirmed diagnosis ?
t'nderline the cause to which death -livuid be charged sta- tistically.
20 Was disease of injury in any way related to occupation of deceased ? 120
Murray
., M. D.
If so, specify,
Arthur C
desanthrop Board of Health.
7/3 1942
21
winthrop
winthrop
DATE OF BURIAL
19.
22 NAME OF
FUNERAL DIRECTOR
Howard S Punolis
ADDRESS
Received and filed.
.19
(Registrar)
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
extracts from the laws on back of certificate.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to Insert a recital to that effect. PARENTS
100m (d)-1-41-4667
1
PLACE OF DEATH
........
St.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
l'lace of Burial, Cremation or Removal.
(City or Town)
July
5
42
EXTRACTS 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 standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed agc, the disease of which he died, defined as re- quired hy 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.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helicf, aerved in the ariny, navy or marine corps of the l'uited States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war. and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall inchide the China relief ex. pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place hetween February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can horder service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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 perinits, or if there is no such board, fromn the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it froin 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 huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case inay be. a satisfactory written statement containing 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 required by law. or in lieu thereof a certificate as liereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian 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 re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a liuman body, not previously interred, from one town to another within the commonwealth cannot be obtained carly enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such reinoval, 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 iu which it has been engaged. such recital shall appear upon the permit. The hoard of health. or its agent, upon receipt of such statement and certificate, shall forthwith countersign 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 neces- sary 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., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until lie has re- ceived a permit so to do from the hoard of health or its agent appointed to issue such permits, or if there is no such hoard, 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 interinent is made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary 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. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment 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 physiclans will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attendance or whose physi- cian is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths caused directly or in- directly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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.
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.
Statement of Occupation .- Precise statement of occupation is very im- portant, so that the relative healthfulness of various pursuits 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 ou account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual 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. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private fantily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
RM R-301 ||
(County
(City or T
2 FULL NAME
(a) Residence. No (Usual place of abod Length of stay : In hospital or
PERSONAL AND
4 COLOR OR
5a If married, widowed, or d
HUSBAND of
(Giv
(Hust
6 Ago of husband or wife if a 7 IF STILLBORN, enter that fa
Mo
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF FATHER (City)
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF MOTHER (City) (State or country)
I HEREBY CERTIFY that a sa filed with me BEFORE the by
(Signature of Age
(Official Designation)
Form H-Death
COPY OF THE RECORD OF A DEATH
Returned to the clerk of.
Winthrop
as is provided in Section 70 of Chapter 1, Public Laws of 1933.
Full name
Harry Michael Hovgaard
Kittery
Place of death
(If outside city or town limits, write RURAL)
Name of hospital or institution 5 Wyman Ave. (If not in hospital or institution write street No. or location)
Length of stay: In hospital or institution
In this community
1 day
Usual residence of deceased: State
Mass.
County
Suffolk
City or Town
Winthrop
Street No.
42 Pleasant Park Rd.
If veteran, name war
Social Security No.
002-01-9992
Sex.
Color
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