USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 59
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
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 ageut, 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 registar 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 interinent 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 forin 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 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
ORM R-305
3 SEX
M
(or) WIFE of
Industry
PARENTS
of the city or town in which the deceased resided as soon as possible after the close of the month In which the death
10 or Business :
occurred. (See Chap. 46, Sec. 12, G. L.)
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorcedEmma C Smith HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife if allve 75 years station
7 IF STILLBORN, enter that fact here.
8 AGE. .81 Years 4 Months. Days
If less than 1 day .... Hours .... Minutos
Usual
9 Occupation :
Optician
Optical Business for Self
11 Soolal Security No.
None
12 BIRTHPLACE (City)
(State or country)
West Hurley New York
13 NAME OF
FATHER
Benjamine Vradenbrugh
14 BIRTHPLACE OF
FATHER (City)
(State or country)
West Hurley New York
15 MAIDEN NAME
OF MOTHER
Mary Brinkerhoff
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
West Hurley New York ?
17 Informant (Address)
Wife
Relation, if any
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
Sept /15/47
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(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 fully.) Arterio sclerotic heart disease treated therefor collapsed in subway
20 Aooldent, suicide, or homiolde (specify) Date of ooourrence 19
Where did Injury ooour ?
(City or town and State)
Did Injury ooour In or about the home, on farm, In Industrial place, or In publio piace? (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, speolfy.
(Signed)
Timothy Leary
M. D.
(Address)
Boston Mass
Date. 9-10 ..... 19 ... 47.
22 WinthropCem Winthrop Mass
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
Sept ..... 13./47
19
23 NAME OF
FUNERAL DIRECTOR
V A Reynolds
ADDRESS
Winthrop. Mass
Received and flied
SEP 29 1947
19
(Registrar of City or Town where deceased resided)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-305 to the clerk
1
PLACE OF DEATH
1 SUFFOLK. (County} BOSTON
(City or Town)
No.
818 Harrison Ave.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
Registered No.
7924 28
(If death occurred in a hospital or institution, give its NAME instead of atreet and number)
2 FULL NAME
Ellis V Vradenbrugh
(If deceased ia a married, widowed or divorced woman, give also maiden name.)
(a) Residenoo. No.
41 Temple Ave.
St.
Winthrop
Mass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution ...
(Before death)
(Specify whether)
years
months
1
days.
In this community
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
25m-(d).6-43-12056
Copies of returna 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
St.
(If U. S.
War Veteran,
speolfy WAR)
Sept. 10/47
M R-302
PLACE OF DEATH
Suffolk (County)
Boston
(City or Town)
No. Veteran's Adm .Hospt
St.
( If death occurred in a hospital or institution,
give its NAME instead of street and number)
Horace M Stevens
(If deceased is a married, widowed or divorced woman, give also maiden name.)
19 Villa Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ...
(Before death)
(Specify whether)
years
month1 5 days.
in this community
15 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE|
W
widowed, or divor Gladys Eaton
(Give maiden name of wife in full)
(Husband'e name in full)
6 Age of husband or wife If allve
51
years
7 IF STILLBORN, enter that faot here.
8 AGE ... 53 ..... Years ... 3 ........ Months. 1 .Days
If less than 1 day .Hours
.Minutes
Insurance Agent
Boston Mutual-Chelsea
11 Soolal Seourity No .. 014-18-4015
Manchester ..... Now ... Hampshif
13 NAME OF FATHER Clarence A Stevens
Lawrence Mass.
Maude L Marsh
Manchester N.H.
17 Informant (Address)
Hospt ... Records .... V.A West Rox.32 Mass,
A TRUE COPY.
ATTEST :
(Registrar of city.of town where death occurred)
Septi 22
19 47
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY, Sept ..... 1
19 ....
4.7., to
I last saw h .... 1m ..... allve on
Sept. 16, 19 47, death Is sald to
have ooourred on the date stated above, at.
.9:35₽
.m.
Duration
immedlate oause of death Acute .... coronary occlusion
Coronary arteriosclerosis and
Due insufficiency Contributing cause;
Hrs
Rheumatic heart disease with aortic
stenosis aortic insufficiency, mitral insufficiency mitral stenosis and
Other conditions.
. (Include pregnCardiac , enlargement, val.vu.a physician
(mitral and aortic damage
Major findings :
and paroxysmal dyspneafyr's Underline
the cause to
Of operations.
which death
Date of
should be charged sta-
Of autopsy .. None
What test confirmed diagnosis?
Clinical laboratory
20 Was disease or Injury In any way related to oooupation of deceased ?
if so, speolfy
J J
Poutas
(Signed)
(Address)
.V.AH .. West .... Roxbury
Date
9-1719
M.
27
21 PLACE OF BURIAL,
CREMATION OR REMOVAWinthrop Cem-Winthrop Mass.
(City or Town)
(Cemetery )
DATE OF BURIAL
Sept .. ... 19/47
19
22 NAME OF
FUNERAL DIRECTOR
Howard .... Reynolds
ADDRESS
Winthrop Mass.
Received and filed SEP 29 1917
19
DATE FILED
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. 16, Sec. 12, G. L.)
50m. (b).6.44-14607
2 FULL NAME
3 SEX
M
married,
HUSBAND of
(or) WIFE of
Usual
9 Occupation :
Industry
10 or Business :
12 BIRTHPLACE (City)
(State or country)
14 BIRTHPLACE OF
FATHER (City)
15 MAIDEN NAME
OF MOTHER
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
-p ... vi itturns of deaths recorded during the prełódź metu wien occurred in your city of town in case the deceased
(State or country)
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
( City or town
Baştan
1
Registered No.
81461 79
W W #1
(a) Residence. No.
(Usual place of abode)
Winthrop Mass.
(If U. S.
War Veteran,
speolfy WAR)
Sept. 16/47
That attended deceased
Sept. 16
19
tiatically.
Relation if any
(Registrar of City or Town where deceased resided)
Entered Service 6-1-17 Discharged 1-14-18 Hon. Sgt. Co.E. 401st Telegraph Bn.
×
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop (City or town making return)
Registrar's Number
180
§ (If death occurred in a hospital or institution { give its NAME instead of street and number)
2 FULL NAME
Melbourne Banks Tewksbury
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
3.9 ..... Edgehill Road
(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 69 years 10 months
days·
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
married
Sa If married, widowed, or divorced
HUSBAND OF
Helen Fairfield
(Give maiden name of wife in full)
(Husband's name in full)
68
years
Usual
9 Occupation:
retired accountant
Industry 10 or Business: general business offices
11 Social Security No ..
028-09-8197
Winthrop
12 BIRTHPLACE (City) (State or country) Mass.
13 NAME OF FATHER John B. Tewksbury
14 BIRTHPLACE OF FATHER (City) (State or country)
Winthrop.
15 MAIDEN NAME
OF MOTHER
Caroline Banks
16 BIRTHPLACE OF MOTHER (City) (State or country) Nova Scotia
17 Helen Tewksbury
Relation, if any WI
Informant (Address) 39 Edcohill Road Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the buryel ar transit permit was issued: Watte
(Signature of Agent off Bowhoffewith or other)
official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
September
16Day)
1947
(Year)
19 Į HEREBY CERTIFY, That I attended deceased from
1
I last saw h ., alive on Meg erail 1/1947 death is said to 30P. M. have occurred on the date stated above, at ... ).2 ..
Immediate cause of death
Carcinoma a bíadia
Due to
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings:
Of operations
in apone
Date of
Of autopsy
What test confirmed diagnosis?
Duration Important
11 0
Important
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way belated to occupation of deceased?
If so. specify
M.D.
(Signed)
238 2500 Dilight But / 19/12 1947
(Address)
21 Winthrop Cemetery, Winthrop Place of Burial. Cremation or Removal. (City or Town)
DATE OF BURIAL
September 18 1947 19
22 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS 174 Winthrop St Winthrop
Healla Officer 9/18/47 Received and filed SEP 19 1947 19
A TRUE COPY ATTEST:
(Registrar)
If deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
it may be properly classified. on back of certificate.
100m-(r)-3-46-18278
1 Winthrop (City or Town) 3 SEX 4 COLOR OR RACE white male (or) WIFE OF 6 Age of husband or wife if alive 7 IF STILLBORN. enter that fact here. 8 Exact statement of OCCUPATION is very important. See instructions and extracts from the laws AGE 69 Years 9 Months 24 Days
PLACE OF DEATH
No. 3.9 Edgehill Road
St.
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
(if so specify WAR)
NO.
Month)
If less than 1 day
Hours ...
Minutes
Mass.
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 required 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 fourteen, 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, specifying 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 section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word '; war" shall include the China relief 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 nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such 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 toub 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 inter- ment, 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 physician 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 required of the attending physician. If death is caused by violence, the medical 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 inade 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 torty-six, that the deceased served in the army. navy or marine corps of the I'nited 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 xolgiven and the physician certifying the cause of death shull thereafter furnish for registration any other necessary 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. I ... (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy 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 received 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 tosuch deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physiclans will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed
(3) Medical Examiners will investigate and certify to alldeaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatistu (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, however, 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 R-301 A
1 PLACE OF DEATH Suffolk Jutt
(County) Winthrop 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.
181
{ {If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
2 FULL NAME
(ILdeceased is a married, widowed or divorced woman, give also maiden name.)
1 Washington
TERRACE
(If nonresident, give clty or town and State)
Length of stay: In mosoltal or Institution
( Before death)
( Specify Whether)
HOSPITAL
years
months
17 days.
In this community
6 0 yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE!
FEMALE White
5 SINGLE
( write the word)
widow
5a If married, widowed, or divoroed HUSBAND of
(Give malden name of wife In firll)
(or) WIFE of
HORACE HOWE
THusband's name in rull)
6 Age of husband or wife if aliva
yaars
7 IF STILLBORN, enter that fact here.
8 AGE 81 Years 7 Months 2 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
at
HOME
Industry 10 or Business :
11 Social Security No.
none
12 BIRTHPLACE (City)
(Siate or country)
HAVERhill
MASS
13 NAME OF
FATHER
Unable to obtain
14 BIRTHPLACE OF
Unable to obtain
FATHER (Clly)
(State or country)
15 MAIDEN NAME
OF MOTHER
unableto obtaino
16 BIRTHPLACE OF
MOTHEP. (City)
Unable to obtain
(State or country)
17 Edith CRoxford Informant ( Address ) I WashingtonGERRACE WIDE
Relation, If any
I HEREBY CERTIFY that a satisfactory standard certificata of death was Aled with me BEFORE the Durlal of Transit permit was Issued : Taller A. Valuerox
(Signature of Agent ( Board of Health he other) Health office 9/10/47
(Oficial Dealgnation) (Date of Issue af Fermit)
18 DATE OF
DEATH
September 17
( Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attendad daoaasad from
may 3
1946, to September 17, 1947
sawher allve on
September 16. 1947, death Is said to
hava occurred on the data stated above, at 300
4.m.
Duration
Immediato cause of daath. Coronary thrombosis
IMPORTANT ....... 1-2 hours
Due to
aufcionelestic Heart Distas
2 cama
Due to.
generalized anteriorcorsi
3 years
Other conditions.
Benigne hephogelocais
( Include pregnancy within 3 months of death)
1 year
....
IMPORTANT
Major findinga:
Of operations
Of autopsy
have
What test confirmed diagnosis?
Clinical + Laboratory
20 Was disease or injury in any way related to occupation of deceased ? No
If so, spaolfy
..........
(Signed) Marie-Traumatic
. M. D.
(Address) 567 Shirley Str Wing fund Data Sept. 17, 1947
21 WirthRIOCEMETERY Winthrop MASS Place of Burial, Cremation og Removal. (City or Town)
DATE OF BURIAL SEPT 204
19.47
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
MASS
Received and Alad TP 221947
19
( Registrar)
100m-(g)-1-45-15510
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 a U. S. War Veteran, G. L. Chap. 46, Section 10, requiree physicians to insert a recital to that effect. PARENTS
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.