USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 76
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6:15PM
.m.
Duration
Immediate cause of death. General Arterio Sclerosis
Chron.
Cerebral Hemorrhage
2yrs .
Due
Right .... Hemiplegia
Due to.
Other conditions.
none
(Include pregnancy within 3 months of death)
Physician
Underline the cause to which death should be charged sta- tistically.
What test confirmed diagnosis ?Q.lini.ca.]
20 Was disease or injury In any way related to occupation of deceased ?...... no
If so, specify
H. V. Dudley
M. D.
(Address)
Cambridge, Mass.
Date.
11/2/19 42
21 PLACE OF BURIAL,
St. Joseph's - Boston
CREMATION OR REMOVAL .. (Cemetery) (City or Town)
DATE OF BURIAL
November 3, 1942
19
22 NAME OF
FUNERAL DIRECTOR
Charles H .Treanor
ADDRESS
E. Boston, Mass.
Received and filed
19
9
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
17
Informant.
Roderick NacInnes (Son
Relation, if any
( Address)
3] Read St winthrop
A TRUE COPY.
Frederick H. Burke
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
November 3, 1942
19
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 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)
F. E. I.
15 MAIDEN NAME
OF MOTHER
Unknown
=
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
TI
Industry
10 or Business :
11 Social Security No. =
12 BIRTHPLACE (City)
(State or country )
"Prince Edward Island
13 NAME OF
FATHER
Angus MacInnes
Major findings :
Of operations.
Date of
Of autopsy
(Signed)
If less than 1 day Hours .. Minutes
Usual
9 Occupation :
none
(Husband's name in full)
6 Age of husband or wife if alive years
(Usual place of abode)
3 SEX
Male
4 COLOR OR RACE|
White
(or) WIFE of
7 IF STILLBORN, enter that fact here.
. VERTICU IT JOBS City Of town Is Cabe LUC deceased
8
AGE ... Q.1 ... Years.
Months.
.. Days
PLACE OF DEATH
Middlesex (County)
R.302
after the close of the month In which the death occurred. (See Chap. 46, Sec. 12, G. L.) of denth should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible min occurity to your thy of town in case the decensed resided in another city or town at the time
50m-10-'39. No. 8427-f
Hatfolk
PLACE OF DEATH
(County)
Roston
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City of town making return)
Registered No.
9588
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Fred Ellsworth MacGregor
(If deceased is a married, widowed or divorced woman, give also maiden name.)
151 Pleasant St
.St.
Winthrop Mass
(If nonresident, give city or town and state)
mos.
1
day's.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE 5 SINGLE
MARRIED
White
WIDOWED
or DIVORCED
(write the word)
Widowed
Sa If married, widowed, or divorced HUSBAND of
Helen E Gibbons
(o:) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
Years
7 IF STILLBORN, enter that fact here.
8 AGE 57 Year 6 Months 27 Days
If less than 1 day
Hours ......
Minutes
Usual
9 Occupation:
Salesman
Industry
Beverages
10 or Business:
11 Social Security No.
010-09-5513
12 BIRTHPLACE (City)
(State or country)
Annapolis Nova Scotia
13 NAME OF
FATHER
John W MacGregor
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Tennessee
15 MAIDEN NAME
OF MOTHER
Hannah Freeman
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nova Scotia
17
Informant
(Address)
J W MacGregor
Relation, if any son
A TRUE COPY.
ATTEST:
(Registrar of city or torm where death occufredy
DATE FILED
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Nov 21, 1942
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. That I attended deceased from
Nov 20/12
19.
Nov 21/12
19
I last saw him ..... alive on ..
NOV 21/4219
death is said
to have occurred on the date stated above, at.
7:45am
Duration
Immediate cause of death Acute myocardial infarction
with pulmonary edema
3 viks
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 ?
Clinic
should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?
(Signed)
. M. D.
(Address)
Boston Mass
Date 11/211/ 42
21 PLACE OF BURIAL.
CREMATION OR REMOVAL .... inthrop Cem, Winthrop
(Cemetery)
(City or Town)
DATE OF BURIAL
NOV 24/42
22 NAME OF
FUNERAL DIRECTOR
Howard S Reynolds
19
ADDRESS Winthrop wass
Received and fled
Nov 25, 1942
19
(Registrar of City or Town where deceased resided)
$26
No.
Peter Bent Brigham Hospital
St. l
(lf U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(L'sual place of abode)
Length of stay : In hospital or institution.
(Specify whether)
years
months
1 days.
In this community
yTS.
(Give maiden name of wife in full)
PARENTS
Date of
If so, specify H = Ben jamin
1 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 Wyswing vi ucatas which occurred is your city of town in case the deceased resided in another city or town at the time
50m-10-'39. No. 8427-f
Suffolk
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 ..
9697~
No. Peter Bent Brigham Hospital
1 (If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.) 204 Lincoln St
St.
Winthrop Mass
(If nonresident, give city or town and state)
mos.
4 days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Male
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
(write the word)
White
or DIVORCED
Widowed
5a If married, widowed, or divorced
HUSBAND of
MaryE Cawthorne ..
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here.
.. years
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Nov 24, 1942
(Month)
(Day)
(Year)
19 IHEREBY CERTIFY.
NOV 20/42
19
NOV 24/42
19.
...
I last saw h ..
1m
alive on
Nov 24/43
death is said
to have occurred on the date stated above, at ...
3:25B
Duration
Immediate cause of death.
Cardiac failure with uremia
mos
AGE
67 Years
Months.
Days
If less than 1 day
Hours .............
Minules
Usual
9 Occupation:
Bank Gurad
Industry
10 or Business:
Federal Reserve Bank
11 Social Security No ..
12 BIRTHPLACE (City)
.....
Chelsea Mass
(State or country)
13 NAME OF
FATHER
Jeremiah Cronin
PARENTS
14 BIRTHPLACE OF
FATHER (City)
..........
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Marr
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17
Informant.
Rita .... Cronin.
(Address)
Relation, if any
daughtd
A TRUE COPY.
ATTEST:
(Registrar of city of town where death becurred)
1
DATE FILED
19
5
(Cemetery) Halden Magsown)
DATE OF BURIAL NOV 28/12
19
22 NAME OF
FUNERAL DIRECTOR
J T White
ADDRESS
E ... Boston Mass
Received and filed
NOV 30/42
19
1
PHYSICIAN
Major findings :
Of operations
Date of ..
Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?.... Clinical
20 Was disease or Injury lo any way related to occupation of deceased ?
If so, specify
H 1/ Ben jamin
(Signed)
M. D.
(Address)
Boston ... Mass
Date ..
11/2 /19/42
21 PLACE OF BURIAL,
CREMATION OR REMOVAL.
Holy Cross Cem
wks
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
That I attended deceased from
to ...
(Give maiden name of wife in full)
years
months
4 days.
In this community
yrs.
(lf U. S.
War Veteran,
specify WAR)
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
John Cronin
(Registrar of City or Town where deceased resided)
A R-302
Suffolk
PLACE OF DEATH
(County)
Boxton
(City or Town)
No. Mass General Hospital
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
9685 8
2 FULL NAME
Wiley S Young
(If deceased is a married, widowed or divorced woman, give also maiden name.)
32 Edgehill Rd
St.
Winthrop Mass
(a) Residence. No .....
(Usual place of abode)
Length of stay: In hospital or institution ...
(Specify whether)
years
months
10 days.
(If nonresident, giye city or town and state)
In this community 6 Brs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
White
(or) WIFE of
62
7 IF STILLBORN, enter that fact here.
8
AGE
65 Years
3
Mon
.12
Days
II Social Security No.
028-01-1896
12 BIRTHPLACE (City)
(State or country)
Nova Scotia
13 NAME OF
14 BIRTHPLACE OF
FATHER (City)
(State or country)Nova Scotia
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country) Nova Scotia
17
Informant.
Lulu M Young
(Address)
50m-10-'39. No. 8427-f
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
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
FATHER
James E Young
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
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive.
Years
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Nov 24, 2+42
(Month)
(Day)
(Year)
19
11/15742
HEREBY CERTIFY.
19
That I attended, deceased from
11/24/42
19.
...
I last saw h ..
im
alive on
11/24/42 19.
death is said
to have occurred on the date stated above, at.
3:200
.m.
Immediate cause of death
Cerebral thrombosis
10 mins
Due to
Cerebral arteriosclerosis 1 yr
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Of autopsy
What test confirmed diagnosis ?
Clinical
20 Was disease or Injury in any way related to occupation of deceased !
If so, specify
(Signed)
G .F. Houser
Boston mass
(Address)
Date.
11/24/42
My. DA
21 PLACE OF BURIAL.
CREMATION OR REMOVAL.
Winthrop Cem-Winthrop
DATE OF BURIAL
Nov 27/
(Cemetery)/112
(City or ToyRss
19
22 NAME OF
FUNERAL DIRECTOR
JE Henderson Co
ADDRESS
Boston Mass
Received and filed
Nov 30/42
19
(Registrar of City or Town where deceased resided)
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
15 MAIDEN NAME
OF MOTHER
Agnes Johnston
Relation, if any (wife
A TRUE COPY.
ATTEST:
(Registrar of city of town where death occurfed),
DATE FILED
19
Duration
If less than I day
Hours
Minutes
Usual
9 Occupation:
Treasurer Richards Co
Industry
10 or Business:
Wholesale Metals
Lulu M Floyd
to ........
Date of.
5
(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
(If U. S.
War Veteran,
specify WAR)
M R-305
1
PLACE Or DEATH
SUREMAL BOSTON (City or Town) Atlantic Works
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH Porter St
BOSTON (City or towa making return) 209
Registered No ....
9786
( (If death occurred in a hospital or institution. G :. / give its NAME instead of street and number)
2 FULL NAME George Burridge
(If deceased is a married. widowed or divorced woman, give also madeo name.)
26 Shirley 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 or town and state)
In this community
yrs.
Inos.
1
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL, CERTIFICATE OF DEATII
13 DATE OF
Nov 27, 1942
(Month:)
(Day)
(Year)
19 ! 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 fuly.) di sea se Chronic cardio vascular
with acute heart failure
20 Accident, suicide, or homicide (specify) ..
Date of occurrence .... Where did Injury occur ?. (City or town and State)
19
Did injury occur in or about the home, on farm, in industrial place, or in public place ?
Manner of
Injury
Nature of Injury
While at work ?
. Was there an autopsy ?
no
21 Was disesse or Injury la any way related to eccapatica of deceased ? I! so, specify
(Signed)
F H Latters
M, D.
(Add-oss)
Date
11/ 27/42
22 Winthrop Winthrop
Place of Burial, Cremation or Re:no- al.
(City or Town)
Relationer ans
.. )
DATE OF BURIAL
Nov 30/42
19
23 NAME OF
FUNERAL DIRECTOR
J F O'Maley
ADDRESS
Winthrop Mass
Roccived and filed
Dec 1, 1942
19
(Registrar of City or Town where deceased resided)
X
No. 3 SEX MARRIED WIDOWED Male White (or) WIFE cf 6 Age of husband or wife if alive 7 IF STILLBORN, enter that fact here. 8 5.8 Yoara Months. . .. . Days AGE Usual 9 Occupation: industry Construction 10 or Business: 12 BIRTHPLACE (City) 13 NAME OF 14 BIRTHPLACE OF FATHER (City) (State or country) Nova Scotia 15 MAIDEN NAME OF MOTHER PARENTS 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 11 Social Security No. 014-12-8853 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-305 to the clerk of the city or town in which the deceased resided as soon as possible (State or country) Nova Scotia
4 COLOR OR RACE, 5 SINGLE
(write the word)
or DIVORCED
Married
Sa If married, widowed, or divorced Many A Adele
HUSBAND of
(Give maiden name of wife in fu.
(Husband's name in full)
5]
Years
If less than 1 day
Hours
Minutes
Foreman Carpenter
FATHER Vincent Burridge
IS BIRTHPLACE OF MOTHER (City) (State or country) Nova Scotia
17 Informant (Address)
& TRUE COPY.
ATTEST:
Gfrancis
(Registrar of city or town where death occurred)
DATE FILED 19
.....
St.
(II U. S. War Veteran, specify WAR).
1
(Specify type of place)
M R-305
8 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-305 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 PARENTS 25m-10-'39. No. 8427-g
PLACE OF DEATH
SUFFOLKI
(City or Town)
No. Cocoanut Grove Club
.....
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON (City or town making return)
350
Registered No ..... 10.151
(If death occurred in a hospital or institution, St. i give its NAME instead of street and number)
2 FULL NAME
Ruth ... L ... Bornstein
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
War Veteran,
specify WAR)
493 Shirley
St. Winthrop Mass
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE 5 SINGLE
W
MARRIED
WIDOWED
or DIVORCED
(write the word)
S
5a If married, widowed, or divorced HUSBAND ci
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Ago of husband or wife if alive. Years
7 IF STILLBORN, enter that fact here.
AGE
17
Years
Months
Days
Ii less than I day
Hours.
Minutos
Usual
9 Occupation:
Student
Industry
10 or Business:
High School
II Social Security No.
12 BIRTHPLACE (City)
Winthrop ..... Mas.s.
(State or country)
13 NAME OF
FATHER
Morris Bronstein
14 BIRTHPLACE OF
FATHER (City)
Russia
(State or country)
15 MAIDEN NAME
OF MOTHER
Mary Kabatchnick
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 Morris Bornstein
Informant
(Address)
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED 19
18 DATE OF
DEATH
Nov 28 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.) Carbonmonoxide poisoning Inhalation of smoke at holocaust
20 Accident, suicide, or homicide (specify).
Date of occurrence ......
Where did
Injury occur ?.
(City or town and State)
19.
Did injury occur in or about the home, on farm, in industrial place, or in public place ?
Manner of
Injury
Nature of Injury
While at work ?
Was there an autopsy?
21 Was disease or lejury lo any way related to occupation of deceased ?.
If so, specify
(Signed)
W.H Watters
M. D.
(Address)
Date
19
22Winthrop Cong
Everett Mass
Place of Burial, Cremation or Removal.
Dec 1
(City or Town)
DATE OF BURIAL
19
23 NAME OF
FUNERAL DIRECTOR
B Schlossberg & Son
ADDRESS
Received and filed
Dec 3 1942
19
(Registrar of City or Town where deceased resided)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
years
.............
MEDICAL CERTIFICATE OF DEATH
(Specify type of place)
M R-305
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-305 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
SUFFOLKI BOUTONJ
(City or Town)
Nc ... 17 Piedmont St
2 FULL NAME
Helen V Brooks
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ...
2.7.Washington.Ave
.............. stWinthrop Mass
(If nonresident, give city or town and state)
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
(write the word)
Female
White
5a If married. widowed, or divorced
HUSBAND o!
(Give maiden name of wife in full)
(or) WIFE c:
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, entor that fact here.
8 AGE 2.7 Years Months. . Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation:
Secretary.
Industry
Boston Paper Board Co
10 or Business:
11 Social Security No.
012-12-9336
12 BIRTHPLACE (City)
(State or country)
Cambridge Mass
13 NAME OF
FATHER
William V Brooks
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston Mass
15 MAIDEN NAME
OF MOTHER
Alice Martin
16 BIRTHPLACE OF MOTHER (City)
(State or country)
Cambridge Kass
17
Informant.
(Address)
Relation, if any
( father
A TRUE COPY
ATTEST:
Francis
1 4ans
( Registrar of city or town where death occurred)
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
13 DATE OF
DEATH
Nov 28, 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.) Carbon monoxide poisoning Smoke inhalation ( Holocaust)
20 Accident, suicide, or homicide (specify) ...... Accident
Date of occurrence.
No.v .... 2 .. ..... 19/1219
Injury occur ?.
Where did
Boston
(City or town and State)
Did injury occur in or about the home, on farm, in industrial place, or in
public place ?
Cocoanut Grove Night Club
Manner of
Injury
Conflagration
Nature of injury
While at work ?
.......
Was there an autopsy ?
21 Was discase or Injury In any way related to cecupation of deceased ?
If co. specify .
(Signed)
A P McCarthy
.M. D.
(Address). ... Boston
Dak1/29/42
22 Winthrop
Winthrop.
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Dec 2, 1942
19
23 NAME OF
FUNERAL DIRECTOR
Daniel F O'Brien
ADDRESS
Cambridge
Mass
Rocoived and filad
Dec. 2, 1942
19
(Registrar of City or Town where deceased resided)
25m-10-'39. No. 8427-g
PARENTS
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON (City or town making return) 231 10008 Registered No (If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
(Specify type of place)
A R-302
Suffolk
PLACE OF DEATH No
(County)
Boston (City or Town) Boston City Hospital
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 ..
9.7.8.5
...
(If death occurred in a hospital or institution, St. 1 give its NAME instead of street and number)
2 FULL NAME
Jeremiah .... Curran
(If deceased is a married, widowed or divorced woman, give also maiden name.)
29 Tewksbury St
St.
Winthrop Mass
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution ...
(Specify whether)
years
months
10 days.
(If nonresident, give city or town and state)
In this community
yrs.
mos. 10
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Nov 28, 1942
(Month)
(Year)
19 I HEREBY CERTIFY.
NOV 25/12
19
to ..
NOV 28/12
.......
19
I last saw h.
.. alive
19.
death is said
to have occurred on the date stated above, at ...
2 ª
....
.. m.
Duration
Immediate cause of death. Syphilitic aortitis with
Minutes aneurysm
mos
Due to
Broncho pneumonia
dys
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Dale of ..
Of autopsy
What test confirmed diagnosis ?
Aut.o.p.s.y.
20 Was disease or Injury In any way related to occupation of deceased ?
If so, specify
(Signed)
M W O' Connell
M. D.
(Address)
Boston ... Míass
Date
11/289/12
21 PLACE OF BURIAL.
CREMATION OR REMOVAL.
Winthrop
Winthrop
DATE OF BURIAL
(Cemetery)
NOV
"30, 1942City of Town)
19
22 NAME OF
FUNERAL DIRECTOR
J F O'Maley
reli]
ADDRESS
Winthrop Mass
Received and fled.
Dec I, 1942
19
(Registrar of City or Town where deceased resided)
1
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
or DIVORCEDMarried
(write the word)
Marie Casey
(Give maiden name of wife in full)
years
If less then 1 day
Hours
Relation, if any (
A TRUE COPY.
ATTEST:
Francis
(Registrar of city or town where death occurred)
DATE FILED
19
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
White
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
(Husband's name in full)
54
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
63
ÅGE
Years
.Months.
Days
Usual
9 Occupation:
Watchman
Industry
10 or Business:
WPA
11 Social Security No.
023-16-9890
12 BIRTHPLACE (City)
(State or country)
Boston Mass
13 NAME OF
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Wiltshire
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
...
(State or country)
Ireland
17
W Curran
Informant.
(Address)
50m-10-'39. No. 8427-f
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
FATHER
Nicholas Curran
1
5
(If U. S.
War Veteran.
specify WAR)
(Day)
That I attended, deceased from
M R-305
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-305 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
25m-10-'39. No. 8427-g
PLACE OF DEATH
SUFFOLK BOSTON
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON (City of town making return) 203
9860
Registered No ..
1
(If death occurred in a hospital or institution,
Ce. I give its NAME instead of street and number)
2 FULL NAME
ALBERT D. ROSENFARB
(If deceased is a married, widowed or divorced woman, give also maiden name.)
40 CUTLER ST
...
years
months
days.
(If nonresident, give city or town and state)
In this community
VTJ.
mos.
days.
(Specify wbether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX MALE
4 COLOR OR RACE 5 SINGLE
WHITE
(write the word)
MARRIED
MARRIED
WIDOWED
or DIVORCED
5a lí married. widowed, or divorced
HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
28
7 IF STILLBORN, enter that fact bere.
8 AGE 32
Years
Months.
Days
Hi less than I day
Hours
Minutes
Usual
MANAGER IN FACTORY
9 Occupation:
Industry LADIES CAPES
10 or Business:
Il Social Security No.
12 BIRTHPLACE (City)
(State or country)
PALESTINE
13 NAME OF FATHER JOSEPH ROSENFARB
PARENTS
15 MAIDEN NAME OF MOTHER
RACHEL GURALNICK
16 BIRTHPLACE OF MOTHER (City) (State or country)
RUSSIA
17 Informant (Address)
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