Town of Winthrop : Record of Deaths 1946, Part 61

Author: Winthrop (Mass.)
Publication date: 1946
Publisher:
Number of Pages: 526


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 61


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by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board 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).


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.


No undertaker or other person shall bury 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 agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the 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 by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician 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 indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


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 heen given up or changed on 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, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT SERVICE NUMBER


1 A


1


PLACE OF DEATH


Juffolk (County) Winthrop (City or TownX No.


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


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


Registered No.


164


St.


(If death occurred in a hospital or institution,


{ give its NAME instead of street and number)


2 FULL NAME


Charles Melvin Shanno


( if deceased Is a married, widowed or divorced woman, give also maiden name.)


(a) Rasidencs. No.


5


Arvin


(Usual place of abode)


Length of stay: In hospital or Institution


( Before death )


( Specify whether )


years


months days.


in this community 35 yra.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Male


4 COLOR OR RACE


white


5 SINGLE


MARRIED


WIDOWED


or DIVORCEO


( write the word)


Married


-


50 If married, widowed, or divorced


HUSBANO of


(Give maiden name of file in full)


(or) WIFE of


( Husband's name in full)


6 Age of husbend or wife if oliva 51


yaars


7 IF STILLBORN, enter that fact here.


8 AGE $4 Years Months Oays


If less than 1 day


Hours


Minutas


Usual


9 Occupation :


Diesel Engineer


Industry


10 or Business :


Bethlen Stal


11 Social Security No.


12 BIRTHPLACE (City)


( Siate or country)


Canton


Maine


13 NAME OF


FATHER


I horas Shannon


PARENTS


14 BIRTHPLACE OF


FATHER (Clty)


...


(State or country)


maine


15 MAIDEN NAME


OF MOTHER


ada Lowjoy


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


maine


17


Informant


( Address)


Margaret Games.


Reistion, if any


15 pourin St.


wide


I HEREBY CERTIFY that a satisfactory standard cartifloats of death was Aled with me BEFORE the burial or transit parmit )was Issued : Walter & Baker


17. 6 .


(Signature of Agent


EH board of Health or other)


9/6/46


(Official Designation) ( Date of Trade of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


OEATH


Sept


4


1946


( Month)


(Day)


( Year)


19 | HEREBY CERTIFY,


That I attendad deosasad from


Aug 19, 1946, to Sept 4, 19.


46


I last saw h ... .. YYY.). alivs on.


Sept 4, 1946 death is said to


have occurred on ths dato statad abova, at.


8:25 P


n.


Immediate cause of death.


Coronary thrombosis


Que to


Coronary Sclerosis


Due to


Other conditions.


( Include pregnancy within 8 months of death)


Mejor Andings : Of oparations


Oate of


Of autopsy


What test confirmed diagnosis ?.


IMPORTANT Physician Underline the cause to which death should be charged sta- tistically.


20 Was disease or injury in any way related to occupation of daceased? NO If so, spsolfy.


(Signed)


763 greenfull


. M. D.


(Address) 147 Shirley Sta Wili y Pata 9-5 1946


21 Winthrop Cemetery Winthrop


(City or Town)


Place of Burial, Cremation or Removai.


DATE OF BURIAL.,


Sept


1946


22 NAME OF


Kirby Bros.


FUNERAL DIRECTOR


AOORESS


210 20 intros ST.


Received and Aled.


SEP 9 ... 1946 19


( Registrar) 1


....


( If nonresident, give city or town and State)


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR)


St.


.......


Margaret Grin


Duration


IMPORTANT


3 days ..... 26 months


100m- (g)-1-45-15510


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 age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.


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 belief, served in the army, navy or marine corps of the United 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 include the China relicf expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen 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 permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement 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 hereinafter 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 medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from 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 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 removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required


by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board 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).


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.


No undertaker or other person shall bury 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 agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the 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 by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is absent from home wben 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 indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


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 on 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, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT SERVICE NUMBER


2-302 1


. SUPFOLZ


(County)


1


(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.


7793


165


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


2 FULL NAME


NATHAN FERAR


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


(a) Residence. No.


(Usual place of abode)


10 WAVEWAL AVE


St.


S.I.N.THROP ..


(If nonresident, give city or town and State)


Length of stay : In hospital or institution.


(Before death)


(Specify whether)


years


months


1


days.


In this community


yT8.


mos.


days


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX MALE


4 COLOR OR RACE


WHITE


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


MARRIED


5a If married, widowed, or divoroed


HUSBAND of


Gus.s ..... E ... AUF TMAN.


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


6 Age of husband or wife if allve years


63


7 IF STILLBORN, enter that faot here.


8


AGE


62


Years


Months ...........


... Days


If less than 1 day .Hours Minutes


Usual


9 Ocoupatlon :


LEATHER WORKER


Industry


10 or Business :


WINSHIP·CO


11 Social Security No ... .


029-07-9248-


12 BIRTHPLACE (City)


(State or country)


RUSSIA


13 NAME OF


FATHER


JACOB R FERAR


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country)


RUSSIA


15 MAIDEN NAME


OF MOTHER


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


RUSSIA


17


Informant.


(Address)


SOM


(.


A TRUE Con Spichal


ming


ATTEST:


(Registrar of city or town where death occurred)


SEPT 10/46


19


DATE FILED


18 DATE OF


DEATH


SEPT 7/46


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY,


That 1 attended deceased from


SEPT 7/46


19


to SEPT 7/46


19


I last saw h IM alive on SEPT 7/46


, 19.


death Is sald to


havs ocourred on the date stated above, at ... 4 .; 45.


m.


Duration


Immediate cause of death


CARDIAC ... FAILURE


Due to ...


.C.O.R.O.NA.R.Y ..... S.C.LE.R.O.S.J.S .... W.L.T.H .... O.C.C.L.J.S .. L.O.N .... J DY


Due to.


Other conditions.


MITRAL STENOSIS


(Include pregnancy within 3 months of death)


Physician


Major findings :


Of operations


Data of.


Underline the catise to which death should be charged sta- tistically.


What test confirmed diagnosis?


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


If so, spsolfy


R OSGOOD


(Signsd)


M. D.


(Address)


Bos.T.O.N


Date 9/8/49


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


WINTHROP


EVERETT


(Cemetery)


(City or Town)


DATE OF BURIAL


S.E.P.T ...


8/46


.19


22 NAME OF


FUNERAL DIRECTOR


B BIRNBACH


ADDRESS


B.O.S.T.ON.


Rsoeived and filed. SEP 2-81946 19


(Registrar of City or Town where deceased resided)


50m- (b) -6-44-14607


Relation, if any


Of autopsy


ABOVE


צ.ב .... 1


PLACE OF DEATH


No. MASS MEMORIAL HOSPITAL


(If U. S.


War Veteran,


speolfy WAR)


NO


X


-302


Essex


(County)


Danvers


(City or Town) Danvers State Hospital No.


St.


2 FULL NAME


Josephine Markell


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


(a) Residence. No.


173 shirley


St.


Winthrop


(Usual place of abode)


5


years


9


months


3


daye.


In this community


yre.


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 Married


or DIVORCED


(Month)


(Day)


(Year)


Sa if married, widowed, or divorced HUSBAND of


(or) WIFE of


( Husband'e name in full)


have occurred on the date stated above,


at


4:05 :


m.


6 Age of husband or wife if allve


78


year


7 IF STILLBORN, enter that fact here.


8


AGE


75 Years.


Months ...


Days


If less than 1 day


Hours ..........


.Minutes


Usual


9 Occupation :


Housewife


Industry 10 or Business :


11 Soolal Security No ....... none.


12 BIRTHPLACE (City)


(State or country)


Lynn


13 NAME OF


FATHER


Timothy Looney


PARENTS


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


15 MAIDEN NAME


OF MOTHER


Mary Donahue


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


17 M.K.McPhillips


Relation, if any


Informant.


(Address)


DOH


A TRUE COPY.


ATTEST :


(Registrar of city or town where death occurred) september 16 19.46


19 I HEREBY CERTIFY, That I attended deceased from


October


1945


tobeptember 9


1946


.. ,


46


er


I last saw h.


alive


september 9


19


death is said to


immediate cause of death


Arteriosclerotic heart disease


Due to.


Due to.


Other conditions.


(Include pregnancy within 3 months of death)


Physician


Major findings:


Of operations.


Date of.


should be charged sta- tietically.


What test confirmed diagnosis? Clinical


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


If so, speolfy


(Signed)


Peter B. hagopian


(Address)


D.SSH


Date


9/13


19.


M. D.


46


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Winthrop, winthrop


(Cemetery),


september 11


(City or Town 19


DATE OF BURIAL


22 NAME OF


FUNERAL DIRECTOR Howard S. Reynolds


ADDRESS


Winthrop


Received and filed CCT E 1946 19


( Registrar of Olite or Town where deceased resided)


50m-(b)-6.44-14607


PLACE OF DEATH


1


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


Danvers


(City or town making return)


Registered No.


166


(If death occurred in a hospital or institution, 3 give ite NAME instead of etreet and number) L (if U. S. War Veteran, specify WAR)


(If nonresident, give city or town and State)


Length of stay: in hospital er institution ..


(Before death)


(Specify whether)


18 DATE OF


DEATH


September


9,


1946


Duration


7 yrs


Underline the cause to


...


which death


DATE FILED


Of autopsy


X


-302


Essex


(County)


Danvers


(City or Town) No. Danvers State Hospital


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


Danvers


(City or town making return)


167


Registered No.


(If death occurred in a hospital or institution,


st.


give its NAME instead of street and number)


2 FULL NAME Agnes Edith Harvie (If deceased is a married, widowed or divorced woman, give also maiden name.)


(If U. S.


War Veteran,


spoolfy WAR)


(a) Residenoo. No.


135 Highland


St.


(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


F male



4 COLOR OR RACE|


White


5 SINGLE


(write the word)


Single


18 DATE OF


DEATH


September


13, 1946


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY, August 17


That I attended , degeased from


1970


weptember


13


19 40


I last saw h.


er


september 13. 46


allve on


death is sald to


(or) WIFE of


(Husband's name in full)


6 Age of husband or wife If allve


yearı


7 IF STILLBORN, enter that faot here.


8 AGE 67 Years Months Days


If less than 1 day Hours .. Minutes


Usual


9 Occupation :


Secretary


Industry 10 or Business :


11 Soolal Security No.


Unknown ..


12 BIRTHPLACE (City)


(State or country)


13 NAME OF


FATHER


William liarvie


Major findings :


Of operations


Date of


should be charged sta- tistically.


What test confirmed diagnosis ?


20 Was disease or Injury In any way related to oooupation of deceased ?.


If so, speolfy. Peter B. hagopian


(Signed)


M., D.


(Address)


DSH


Dat


9/13/146


.19.


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Woodlawn


Everett


(Cemetery)


(City or Town)


DATE OF BURIAL


September 16


22 NAME OF


FUNERAL DIRECTOR


ADDRESS


Winthrop


Howard v.


Reynolds.


ATTEST:


mas


(Registrar of city or town where death occurred)


DATE FILED september 16. 19 46


Received and filed CCT F. 1946


19


X


(Registrar of City or Town where deceased resided)


50m- (b) ·6-44-14607


17 M.K.McPhillips


Relation, if any


Informant. (Address)


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Scotland


15 MAIDEN NAME


OF MOTHER


( Crawford)


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


Scotland


Of autopsy


Clinical


Physician


Underline the cause to which death


PARENTS


Arteriosclerotic heart disease


Due to.


Due to.


Other conditions.


(Include pregnancy within 3 months of death)


Duration


Immediate cause of death


have ooourred on the date stated above, at ...


1:45 a


m.


51 If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


MARRIED


WIDOWED


or DIVORCED


Winthrop


(Usual place of abode)


(Specify whether)


1


PLACE OF DEATH


A TRUE COPY.


PLACE OF DEATH


301 A


1


No.


Suffolk (County) Winthrop (City or Town) 48 Belcher St


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


To be filed for burial permit with Board of Health or its Ageng. 168


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


2 FULL NAME


Maria F. Kanairy Flanagan


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


(a) Residence. No.


48 Belcher St


(Usual place of abode)


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.


1


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


1 Male


4


COLOR OR RACE


White


5 SINGLE


(write the word)


MARRIED


WIDOWED


Or DIVORCEDWidowed


5a If married, widowed or divorced HUSBAND of ..


(or) WIFE of


Ma pre maiden


"Aª1de


Flanagan"


(Husband's name in full)


6 Age of husband or wife if alive years


: 7 IF STILLBORN, enter that fact here.


&GE75


ĂGE


Years


Months


Days


If less than 1 day


.. Hours


Minutes


Usual


9 Occupation:


Housewife


Industry


10 or Business:


Own Home


11 Social Security No.


12 BIRTHPLACE (City).


(State of Country)


Boston


Massachusetts


13 NAME OF


FATHER


Thomas Kanairy


14 BIRTHPLACE OF


FATHER (City)


(State or Country)


Ireland


15 MAIDEN NAME


OF MOTHER


Margaret Handrahan


16 BIRTHPLACE OF


MOTHER (City).


(State of Country)


Ireland


17 Informant Mrs Grafton Wood. (all'ghter)


(Address 48 Belcher St Winthrop I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the, burial or transit permit das issued: Halter GBaker


(Signature of Agent - Board of Health or other)


Sept 16/46


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH




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