USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 9
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75 | Part 76 | Part 77 | Part 78 | Part 79 | Part 80 | Part 81 | Part 82 | Part 83 | Part 84 | Part 85 | Part 86 | Part 87
2
m.
Immedlate oause of death.
Duration IMPORTANT
Due to
- Gelabert
Other conditions
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings:
Of operations
Date of
Of autopsy
Same as above
What test confirmed diagnosis? Eulaprepar
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to oooupation of deceased?
If so, specify .......
Fredulla
(Signed)
M. D.
(Address) 1905
Date 230 19 45
21
Italy Gross
malden
(City or Town)
l'lece of Burial/ Cremetion or Remove January 31 DATE OF BURIAL ..
19 44
22 NAME OF
FUNERAL DIRECTOR ..
m. R.Kelly
ADDRESS
11 Meridian St, O E.B.
Received and Aled
19
( Registrar)
100M-6 - 2-42-8855
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was & U. S. War Veteran, G. L. Chap. 46. Seotlon 10, requires physloians to insert a reoltal to that effeot.
1
PLACE OF DEATH
Winthrop (City or Towy) No. Winthrop Community Hospital (If death occurred In a ho r
give Its NAME Instead of street, aud nuniber) PHYSICIAN - IMPORTANT
2 FULL NAME James M. Barry
( U deceased Is a married, widowed or divorced woman, 12/ Locust
ve also maiden name.) Winthrop
St.
(If nonresident, give clty or town and State)
Length of stay: In hospital or Institution
.
(Before death)
(Sperify whether)
Glu.
tate) hv 6
1944
4
(Give maiden name of wife In full)
Joseple M. Barry
Rotation At any
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer ahall forthwith, after the death of a person whoin he has atteruled during his last Illness, at the request of an undertaker or other authorized person or of snr meniber of the family of the deceased, furnish for registration a standard certifcate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. defined as re- quired by section one. where same was contracted. the duration of his lsst illness, when laat seen alive by the physician or otcer and the date of his death ... Gen. Lawa, Chlap. 46, Sec. 9.
A' physician or officer furnishing a certificate of death aa 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 belief, served in the sriny, navy or marine corps of the I'nited Sistes 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 saine. For neglect to comply with any provision of this section, auch physicien or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-reven of said chapter one humlred and fourteen, the word "war" shall include the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexi- can border service of nineteen hundred aud sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undartakar or other parson ahall hury 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 lesue such permits, or if there is no such board, from the clerk of the town where the person dled; and no undertaker or other person shall exhume a human body aud remove it froin a town. from one cenietery 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 aforexaid 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 he, a satisfactory written statement containing the facts required by law to he 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. o1 in lieu thereof a certificate as liereinafter provided. If there is no attending physician. or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medl- cal examlier ahall make such certificate. If such a permit for the removal of a human body, not previously interred, froin one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession ot the undertaker desiring to make such removal shall constitute a permit for ruch removal; provided, that such body shall be returned to the town from which it was removed 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 containa a recital, aa 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 recitai shall appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate, shall forthwith countersign it and trananilt 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 uiay require .- Chap. 114. Sec. 45, G. L., ( Tercentenary Edition ).
No undertaker or other person shall hury a human body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the board of health or its sgent appointed to issue such permits, or if There is no such board, from the clerk of the town where the body la to be buried or the funeral is to be held, or from s l'eraun appointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114. Sec. 46. C. L., (Tercentenary Editiou).
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 lils county the body of such a person, he shall forthwith go to the place wilere the Innly lies aud take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla 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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Haalth physlolans will certify to such deatha only as those of persons who, though disahled hy recognized disease unrelated to any form of lujury. have died without recent medicai attendance or whose phyat- cian ia ahsenl from home when the certificate of death Is needed.
(3) Medloal Examiners will investigate and certify to all deaths sup- posably due to Injury. These include not only deaths caused directly or in- directly hy traumatiam (Including resulting septicemia). and hy the action of chemical (drugs or poisons), therinal, or electrical agents, aml deaths following abortion, but also deaths from diseass resulting from Injury or Infection ralated to occupation, the sudden deaths of persons not disablad by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causee death, not the mode of dying. e. g., hrart fallure, asphyxia, asthenia, etc. Aa 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.
Statemant of Occupation .- Precise statement of occupation ia very im- portant, so that the relative healthfulness of various pursuits cau he known. Make some eutry 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 aa at school or at home. For a woman whose only occupatiou was that of honie housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terma, as housekeeper-private family, cook-hotel. etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
FORM R-302
NORGELA
The Commontura'th of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BROOKLINE
(City or town making return)
58 21 1
Registered No.
- (If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Matilda Tocker
(If deccased is a married, widowed or divorced woman, give also maiden nanie.)
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
15.Underhill
St.
Winthrop ,Mass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
years
months
days.
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)
Widowed
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) 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
73
Years
Months
Days
If less than 1 day
Hours
Minutes
Due to
Usual
9 Occupation :
None
Industry
10 or Business :
Il Social Security No.
None
12 BIRTHPLACE (City)
(State or country)
Germany
13 NAME OF
FATHER
Moses Seigel
14 BIRTHPLACE OF
FATHER (City)
(State or country )
Germany
15 MAIDEN NAME
OF MOTHER
Adelheld (Unknown)
16 BIRTHPLACE OF
MOTHER (City)
(State or country )
Germany
17
Harry Fishman
Relation if. any
friend )
Informant
( Address)
18 Beach Rd. Winthrop, Mass.
A TRUE Car Thur & Shimmera
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
January ..... 31 , .... 1944
19
18 DATE OF
DEATH
January
29
(Month)
(Day)
(Year)
to ..
19 | HEREBY CERTIFY,
That I attended deoeased from
November ..... 2 .... , 19 ..
43
January ... 29
19
44
I last saw h .. @ ........ alive on
Jan. 28 , 1944, death is sald to
have occurred on the date stated above, at 12 .: 28 .... p. ...... m.
Duration
Immediate cause of death Arteriosclerotic .... HeartDisease Cardiac ... Decompensation
years .. 1 .... yr
4-5 ms
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations.
Date of
Of autopsy
What test confirmed diagnosis ?
20 Was disease or injury in any way related to occupation of deceased ?.... nQ.
If so, specify
(Signed).
William ... J ..... Shriber
M. D.
(Address) 770Center Street
Date Jan. 30, 44
21 PLACE OF BURIAL,
CREMATION OR REMOVAL Montifiore -- Montvale
(Cemetery)
(City or Torp?
194
22 NAME OF
FUNERAL
ADDRESS
Received and filed
8-1944
19
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD PARENTS
MARGIN RESERVED FOR BINDING
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
PLACE OF DEATH
(County)
1
BROOKLINE (City or Town) David Memorial Nursing Home, 61 Park Streetst.
No.
(Specify whether)
1944
Solomon locker
Due to
Anasarca
Physician Underline he cause to vhich death hould be charged sta- tistically.
DATE OF BURIAL
Jan. 31
DIRECTOR
Ben jamin .......... Solomon
420 Harvard St., Brookline
M R-302
PLACE OF DEATH
Middlesex
(County)
Medford
(City or Town)
No Lawrence Mem, Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Medford (City or town making return) 22
Registered No
(If death occurred in a hospital or institution,
St. 1
give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
19 Bellevue Ave.
St.
Winthrop
(If nonresident, give city or town and state)
Length of stay: In hospital or institution.
(Specify whether)
hospital ...
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
2 FULL NAME
Adams
(.Baby ... )
(a) Residence. No.
(Usual place of abode)
3 SEX
female
4 COLOR OR RACE 5 SINGLE
white
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
7 IP STILLBORN, enter that fact here.
8
AGE
Years
Months
.. Days
Usual
9 Occupation:
Industry
10 or Businessı
II Social Security No.
12 BIRTHPLACE (City)
Medford
Mass
(State or country)
13 NAME OF
FATHER
Lewis Adams
14 BIRTHPLACE OF
FATHER (City)
Winthrop
15 MAIDEN NAME
OF MOTHER
Jean Scully
PARENTS
Dostan
17
Informant.
Lewis Adams
50m-10-'39. No. 8427-f
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
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
(State or country)
Mass.
(write the word)
single
(Give maiden name of wife in full)
Years
stillborn
If less than I day Hours Minutes
Prematurity
Due to
Chronic Nephri tic
Due to
Toxemia of mother
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Date of ..
Of autopsy
What test confirmed diagnosis ?
20 Was disease or lajary In any way related to occupation of deceased ?
If so, specify,
Emilio D' Errico
. M. D.
(Address) .................
Date
1/5 19
44
21 PLACE OF BURIAL.
CREMATION OR REMOVAL Oak Grove
(Cemetery)
Jan. 7. 1944
Medford
(City or Town)
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
Joseph. L. Fitzpatrick
ADDRESS
Medford, Mass.
.....
Received and fled
19
DATE FILED
Jan. 11, 1944
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
January
5
1944
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
Jan.
5
19
4.4
to
That I attended deceased from
Jan.
5
19
44
I last saw h ............ alive on
19 ........ ,
death is said
to have occurred on the date stated above, at ...
.......... m.
Immediate cause of death ....
Stillborn
Duration
Underline the cause to which death should be charged sta- tistically.
18 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
(Address)
19 Bellevue St. Winthrop
A TRUE COPY.
ATTESTI
(Registrar of city or town where death occurred)
(Registrar of City or Town where deceased resided)
1
(Signod)
322 Boston Ave.
-
(If U. S.
War Veteran,
specify WAR)
FORM R-302
1
(City or Town)
No.
Long Island Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return) 23
Registered No.
268
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
William J. Lynch
(If deceased is a married, widowed or divorced woman, give also maiden name.)
210 Winthrop
St.
Winthrop,
Lass .
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution.
(Before death)
(Specify whether)
8 years
months
days.
In this community
65 yrs. 10 mos.
4
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan
5
1944
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
May 18
19.35.
to ..
That I attended deceased from
Jan 5/44
19
I last saw h
im
.. alive on.
Jan 5/44
19
.. , death Is sald to
have occurred on the date stated above, at.
9
P
m.
Duration
Immediate cause of death.
Coronary thrombosis
minutes
Hypertensive cardiovascular disease
yrs
Due to ..
hypertrophic arthritis
vrs
Usual
Leather sorter
Industry
unknown
Il Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
Boston, Mass.
13 NAME OF
FATHER
Edward Lynch
Major findings:
Of operations.
Date of
should be
charged sta-
tistically.
What test confirmed dlagnosis ?
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, speolfy.
J. V. Sacchetti
(Signed)
(Address)
L. I. HOSD.
Date
1/5
...
M. P.
19
Mass.
21 PLACE OF BURIAL, Winthrop Cem-winthrop,
CREMATION OR REMOVAL ..
(Cemetery)
(City or Town)
DATE OF BURIAL
Jan 8/44
19
22 NAME OF
FUNERAL DIRECTOR
Kirby Bros
ADDRESS
winthrop
Mass.
Received and filed
FEB 11 1944
19
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
(a) Residenoe. No.
(Usual place of abode)
3 SEX
M
4 COLOR OR RACE
W
Sa If married, widowed, or divorced
HUSBAND of
(or) WIFE of
7 IF STILLBORN, enter that fact here.
8
65
10
4
9 Ocoupation :
10 or Business :
14 BIRTHPLACE OF
FATHER (City)
PARENTS
17
Informant
(Address)
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk
(State or country)
Ireland
5 SINGLE
(write the word)
Married
MARRIED
WIDOWED
or DIVORCED
Julia Hennessey
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if alive years
AGE
Years
Months.
.Days
If less than 1 day
Hours
Minutes
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Underline the cause to whichdeath
15 MAIDEN NAME
OF MOTHER
Margaret Leahy
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston, Mass.
Long Island Hosp
(
Relation, if any
A TRUE COPY.
Svancis
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
Jan 10/44
19
Of autopsy
4
(If U. S.
War Veteran,
specify WAR)
PLACE OF DEATH
(County) T
M R-302
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 PARENTS
PLACE OF DEATH
Middlesex (County)
Malden (City or Town) Malden Hospt.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Malden
(City or town making Return)
Registered No. (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.)
34 Perkins
.St.
Winthrop
(If nonresident, give city or town and state)
years
months
days.
In this community
yrs.
mos.
day !.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
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)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
Still born
8
AGE
-
Years.
.... Months.
......
.... Days
If less than I day
Hours.
.. Minutes
Usual
9 Occupation:
Industry 10 or Business:
Il Social Security No.
Halden
12 BIRTHPLACE (City)
(State or country)
Lass:
13 NAME OF
FATHER
Ben Bramson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
15 MAIDEN NAME
OF MOTHER
Chelsea
18 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nass.
17 Ben Bramson
Relation, if pay rathe
Informant.
(Address)
34 Perkins St. Winthrop
A TRUE COPY. 00
ATTEST:
(Registrar o or toun where death occurred)
DATE FILED Jan.19, 1944
.19
18 DATE OF
DEATH
January 7, 1944
(Month)
(Year)
19 I HEREBY CERTIFY,
That I attended deceased from
19 ........ , to.
19.
I last saw h ............ alive on
.....
19. death is said
to have occurred on the date stated above, at .....
.......
... m.
Duration
Immediate cause of death ...
Due to
Still born
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Of autopsy
What test confirmed diagnosis ?
Dorothy H. Bensusil Was disease or Injury In any way related to occupation of diceased ?
If so, specity.
Jacob Frank Deich
(Signed)
(Address)
475 Com. Ave . Bos Date
1/7/44
M. D.
21 PLACE DOBUBary Mutual,
Montvale
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR
B.F.Solomon
ADDRESS
420 Harvard St. Brooklin
Received and Bled.
FEB 14 1944
19
(Registrar of City or Town where deceased resided)
1
No.
Bramson
(a) Residence. No ...
(Usual place of abode)
Length of stay: In hospital or institution ..
(Specify whether)
(I U. S. War Veteran, specify WAR).
Underline the cause to which death should be charged sta- tistically.
CREMATION OR REMOVAL
Jancemetery, 1944
(City or Town)
PHYSICIAN
Date of.
Years
RM R-305
PLACE OF DEATH
SUFFOLK BOSTON
(City or Town)
470 Center St.
The Commonfocalth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BONTON
(City or town making return)
575
Registered No. § (If death occurred in a hospital or institution, St.
¿ give its NAME instead of street and number)
Helen Nassif
(If deceased is a married, widowed or divorced woman, give also maiden name.)
180 Winthrop St.
St.
(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
yrs.
8 mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Solomon Nassi
(Husband's name in full)
6 Age of husband or wife If allve
70
years
7 IF STILLBORN, enter that fact here.
8 AGE 60 Years Months. Days
If less than 1 day Hours ... Minutes
Usual
9 Occupation :
Housework
11 Social Security No.
none
12 BIRTHPLACE (City)
(State or country)
Syria
13 NAME OF
FATHER
Ameen Attalla
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Syria
15 MAIDEN NAME
OF MOTHER
Hadela Haddad
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Syria
Relation if ( ... daughter.
Informant
(Address)
A TRUE COPY.
Francis
X4a
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED Jan .... 17/44 19
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 1 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.) Hypertensive heart disease with latent diabetes treated therefor
20 Accident, sulolde, or homlolde (specify)
Date of occurrence.
19
Where did
Injury occur ?
(City or town and State)
Did Injury oocur In or about the home, on farm, In Industrial place, or In publlo place?
(Specify type of place)
Manner of Injury
Nature of
Injury
While at work?
Was there an autopsy?
no
21 Was disease or Injury In any way related to occupation of deceased?
If so, specify
(Signed)
T. Leary
Date:
1/13
.. ,
19
44
22
Oak Grove
Springfield, Mass.
Place of Burial, Cremation or Removal.
(City or Town)
any
DATE OF BURIAL
Jan 17 /44 19
23 NAME OF
FUNERAL DIRECTOR
H. Reynolds
ADDRESS
Winthrop, Mass.
Received and filed
FEB 11 1964
19
(Registrar of City or Town where deceased resided)
25m (h)-1-41-4667
No.
2 FULL NAME
(a) Residence. No.
(Usual place of abode)
3 SEX
F
10 or Business :
PARENTS
17
v. Reynolds
occurred. (See Chap. 46, Sec. 12, G. L.)
of the city or town in which the deceased resided as soon as possible after the close of the month in which the death
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-305 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
Industry
At home
4 COLOR OR RACE
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.