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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