USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 24
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Not learned
MOTHER (City)
(State or country)
Ireland
17 Hospital Records ( Relation, if any
Informant
(Address)
A TRUE COPY.
ATTEST :
C.Wantto Naughto
....
Supt
(Registrar of city or town where death occurred)
DATE FILED
Jan. 15
1948
RFBY CERT 19
47
Jan. 15
19
to
That I attended
deceased
4'8
1 last saw h.
im .... alive on
Jan
15
1948 death is said to
6 Age of husband or wife if alive
years
Due to. Generalized Arteriosclerosis
Yrs.
Due to
12 BIRTHPLACE (City)
(State or country)
Mass.
East ... Boston
13 NAME OF
FATHER
Thomas Kennedy
Physician Underline the cause to which death
tistically.
-
(City or Town)
No.Tewksbury State Hospital and Infirmary
Registered No.
9
(If U. S.
War Veteran,
speolfy WAR)
Winthrop
3 SEX
RM R-302
Suffolk
(County)
Boston
(City or
No.
Freda Levy
2 FULL NAME
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
53 Trident Ave.
St.
Winthrop.
Mass,
(If nonresident, give city or town and State)
Length of stay : In hospital or institution ..
(Before death)
(Specify whether)
years
months
14
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE|
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
'or DIVORCED
Widowed
5a If married, widowed, or divoroed
HUSBAND of
( Give maiden name of wife in full)
(or) WIFE of
Samuel ... Levý
(Husband's name in full)
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that faot here.
8
AGE
Years
Months.
Days
If less than 1 day Hours .Minutes
Usual
9 Ocoupation :
Housewife
Industry 10 or Business :
11 Social Security No.
None
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Samuel Schwam
PARENTS
14 BIRTHPLACE OF
Russia
FATHER (City)
(State or country)
15 MAIDEN NAME OF MOTHER Gertrude --
If so, speolfy.
(Signed)
Frank Ratner
M. D.
(Address)
Beth Israel Hospt Date 2-25 19.
48
21 PLACE OF BURIAL,
Abram son (Lebanon)
CREMATION OR REMOVAL
(Cemetery)
West itRox bury
DATE OF BURIAL
Feb. .. 27/48
22 NAME OF
FUNERAL DIRECTOR
B ... F ..... Solomon
ADDRESS
Brookline ... Mass.
Received and filed. APR 131943 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-808 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
50m-(b)-6-44-14607
17
Hyman Lovy~
Relation, &t apy
Informant. ( Address)
Merhall Frifanning
ATTENT:
(Registrar of city or town where death occurred) March 1 .19
DATE FILED
18 DATE OF
DEATH
(Month)
Feb. 25/48
(Day)
(Year)
19 | HEREBY CERTIFY,
That | attended deceased from
Feb .1.1
148
to
Feb. 25
19
48
I last saw h ....... er ... allve on.
Feb.25
19.48, death Is sald to
have occurred on the date stated above, at
9:30AM
m.
Duration
immedlate oause of death Pulmonary fibrosis
Bronchiectasis
"5"Yr's
Due to.
Due to.
R.L.L.Lobar pneumonia
SWks.
Other conditions
(Include pregnancy within 3 monthe of death)
Physician
Major findings: None
Of operations
Date of
should be
charged sta- tietically.
Of autopsy
As above
What test confirmed diagnosis ?.
autopsy
No
20 Was disease or injury in any way related to oooupation of deceased ?
Underline the cause to which death
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
19650
Registered No.
60
1
PLACE OF DEATH
Beth -srael Hospital
(If death occurred in a hospital or institution,
St.
. { (If death
give its NAME instead of street and number)
(If U. S.
War Veteran,
speolfy WAR)
-
(a) Residence. No.
(Usual place of abode)
63
٠
M R-302
1
PLACE OF DEATH
Suffolk (County)
Boston (City or Town)
No. Carney.Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOST
(City or town making return)
Registered No.
216261
(If death occurred in a hospital or institution, St. { give give its NAME instead of street and number)
2 FULL NAME
Gaetano Oliva
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Wilshire
St.
(If U. S.
War Veteran,
spoolfy WAR)
Winthrop
2
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
...
years
1
months
days.
In this community
yrs.
1 mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE| 5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEAgle
5ª If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve
years
7 IF STILLBORN, enter that faot here.
8
24
Years Months. Days
If less than 1 day Hours. Minutes
Usual
9 Oooupation :
farmer
Industry
10 or Business:
Farm
11 Soolal Security No.
none
12 BIRTHPLACE (City)
(State or country)
E Boston
13 NAME OF
FATHER
Vincent Oliva
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Vincenza Miranda
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17
Informant
(Address)
father
Relation, if any
100
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
3/5/48
.19
Received and filed 7 29 1948 19
DATE FILED
18 DATE OF
DEATH
Mar. 1/48
(Month)
(Day)
(Year)
19 1
4535948
19
3/1/48
19.
CERTIFY,
to
attended deceased from
I last saw h ...
1m ... allve on
3/1/48
19
death Is sald to
have ocourred on the date stated above, at
4.55a
Durasian
Immedlate cause of death. Uremia
Due to.
bilat .... hypoplastic ..... kidneys
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations.
Underline the catise to which death
Date of
should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?
20 Was disease or injury In any way related to oooupation of deceased ?.
If so, speolfy
JP Fotopoulos
(Signed)
(Address)
Carney Hosp
Date
3/1/48
M. D.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop-Winthrop
DATE OF BURIAL
3/4/48
(City or Town)
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Everett
S Rocco
(Registrar of City or Town where deceased resided)
Y
50m- (b)·6-44-14607
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-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
AGE
W
1
(Give maiden name of wife in full)
By Tel "Probably congenital disease of kidneys" Dr. Fotopoulos
Date of entering military service 3/19/43 Date of discharge 3/13/46
Rank Rating
PFC
Org and outfit
Bat B 897th F A Bat.
Service No. 31 305024
M R-302
3 SEX
F
(or) WIFE of
8
AGE.
73 Years
Industry
10 or Business :
11 Soolal Security No.
PARENTS
(State or country)
Informant
(Address)
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-802 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city of town in case the deceased
(State or country)
4 COLOR OR RACE|
N
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or 'divorced
HUSBAND of
Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If allve 15
yours
7 IF STILLBORN, enter that faot here.
If less than 1 day
.. Hours
Minutes
Usual
9 Ocoupation :
Housewife
12 BIRTHPLACE (CityPoston
(State or country)
13 NAME OF
FATHER
William Flaherty
14 BIRTHPLACE OF
FATHER (City)
Boston
15 MAIDEN NAME
OF MOTHER
Catherine Merrigan
16 BIRTHPLACE OF
MOTHER (City)
Boston
17 Husband
Relation, if any
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
3/11/48
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March 8/48
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
2/12/48
19
to ......
....
3/8/18
19.
That I attended deceased from
I last saw h .............. allve on.
3/8/48
19
death Is sald to
have occurred on the date stated above, at
5 45A
mt.
Durasian
Immedlate cause of death. Carcinoma tosis . general
1 yr
Due to.
carcinoma It breast
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Physician Underline
Major findings :
Exploratory laparaton the cause to
Of operations.
·
Date
of
2/27/48
which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis?
20 Was disease or Injury in any way related to occupation of deocased ?.
If so, specify ......
IT'S Thorndike
(Signed)
M. D.
(Address)
Mase Gon Hasa
Date ...............
19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL.
Winthrop
Winthrop
(Cemetery )
3/17/18
19
(City or Town)
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
TEOMaley
ADDRESS
Winthrop
19
(Registrar of City or Town where deceased resided)
50m-(b)-6-44-14607
PLACE OF DEATH
(County)
1
(City or Town)
Mass
Gen
Hosp
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.
2258 62
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
1
(If U. S.
War Veteran,
specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
54 Center
St.
Winthrop
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
years
months
2 5days.
In this community
yrs.
mos. 25
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
2 FULL NAME
Cecile M. Cotter
The Baker Mem ......
No.
Received and filed APR 221943
4
Months.
Days
RM R-302
Suffolk
(County)
Boston
(City or Town)
No.
Beth Israel Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
Registered No.
2410
63
1
(If death occurred in a hospital or institution,
give ite NAME instead of street and number)
2 FULL NAME
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
17 ..... Cutler
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ..
(Before death)
(Specify whether)
....
years
months 12
da y B.
In this community
yre.
.12
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
F
4 COLOR OR RACE
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Samuel .... Cohen
(Husband'e name in full)
have occurred on the date stated above, at
2 .;. 2.0AM .. m.
Duration
Immediate cause of death.
Cerebro vascular accident
5-6 Das
7 IF STILLBORN, enter that faot here.
8 AGE Years. 73 Montha. Days
If less than 1 day .. Hours .Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
At Home
11 Soolal Security No ....
12 BIRTHPLACE (City)
(State or country)
New York City N.Y.
13 NAME OF FATHER Abraham Levy
Major findings:
Of operations
None
Underline the cause to which death
Of autopsy None
What test confirmed diagnosis ?.
20 Was disease or Injury In any way related to oooupation of deceased ?
If so, speolfy.
No
(Signed)
M. W ... Homo.lsky.
Beth Israel Hospt.
M.48.
(Address)
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
March IT/48
Tifereth Israel of Winthrop
Everett was6.
of Town
19
A TRUE ROPY. hal Hanning
ATTEST ...
(Regietrar of city or town where death /occurred)
DATE FILED
.March 15 19 48
Reoelved and filed.
APR 231948
.19
(Registrar of City or Town where deceased resided)
50m-(b) -6.44-14607
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-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
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 (Addrese)
Mrs E Sanda Blation Daughter
7
r DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
L Levino
ADDRESS
Brookline Mass.
Date
3-10
19
Years
Due to.
Hypertension
Other conditions
Congestive heart failure
Physician
(Include pregnancy within 3 months of death)
"Years
Due to
Cerebral arterio sclerosis
March 10/48
(Day)
(Year)
19 | HEREBY CERTIFY,
Feb.2.8.
19
48
to
That i attended deceased from
March 9
19
I last saw h .... @r ...... alive on.
March 9
19 48
death Is said to
6 Age of husband or wife if allve years
St.
Boston
(City or town making return)
1
PLACE OF DEATH
Rose Cohen
(If U. S.
War Veteran,
spoolfy WAR)
Winthrop
Mass .
(Usual place of abode)
18 DATE OF
DEATH
(Month)
Date of.
should be charged sta. tietically.
RM R-302
1
Boston
(City or Town)
...
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
2400 64
(If death occurred in a hospital or institution,
give ite NAME instead of etreet and number)
2 FULL NAME
Philip Schiff
(If deceased ie a marrfed, widowed or divorced woman, give also maiden name.)
271 Shirley
St.
Winthrop Mass.
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution.
(Before death)
(Specify whether)
....
years
2 months
days.
In this community
yre.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
M
4 COLOR OR RACE
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
(Month)
(Day)
(Year)
5a If married, widowed, or divorced HUSBAND of
Lizzie Strachun
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if allve
63
years
7 IF STILLBORN, enter that fact here.
8 AGE 61 Years Months. Day
If less than 1 day .Hours .. Minutes
Usual 9 Ocoupation :
Printer
Industry
10 or Business :
Print Shop
11 Soolal Security No .. 021-20-2685
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Louis Schiff
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Ida S -
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17 informant. (Address)
DATE OF BURIAL
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
(Cemetery )
March ... 11/48
19
Int .Worker's Order Cem
(city GRFett
22 NAME OF
FUNERAL DIRECTOR
L Schlossberg
ADDRESS
Mattapan Mass.
Received and filed. APR 2- 1943
19
DATE FILED
(Registfar of city or town where death occurred) March 15/48
18 DATE OF
DEATH
March 10/48
19 I HEREBY CERTIFY,
No.v ...... 10 ...
19 ... 47 ....
to
That I attended deceased from
March ... 1.0 19 ... 48 ..
I last saw h
im ailvo on
March 10, 128
death is said to
have occurred on the date stated above, at
1,30₽
m.
Duration
Immediato cause of death. Cachexia and emaciation
....
May/47
Due to.
Carcinoma of sigmoid
Due to.
Metastases to liver
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Adenoca.sigmoid
Date of
May 1947
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or Injury in any way related to occupation of deceased ? No.
If so, specify.
H Bengloff
(Signed)
M. D.
(Address)
Boston .. Mas.s.
Date.
3 .-. 109
48
Path.exam.
Physician Underline the cause to which death should be charged sta- tistically.
50m-(b)-6-44-14607
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased 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-808 to the clerk
PLACE OF DEATH
Suffolk
(County)
No.
Starr Nursing Home
St.
(If U. S.
War Veteran,
speolfy WAR)
(Registrar of City or Town where deceased resided)
M R-302
1
PLACE OF DEATH
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
Boston
(City or town making return)
Registered No.
25365
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
Addie L Eaton
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No.
90 Sagamore Road
St.
(If nonresident, give city or town and State)
26
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX F
4 COLOR OR RACE
W
MARRIED
WIDOWED
or DIVORCED
Widow
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
.an. ..... ].5 .........
19
48
to
That I
attended deceased from
March 13. 48
I last saw h ........ @r.alive on
March 1219 48 death Is said to
have ooourred on the date stated above, at
Duration
immedlate cause of death
Broncho pneumonia
Days
7 IF STILLBORN, enter that faot here.
AGE
8
77
Years
Months.
Days
If less than 1 day Hours. .Minutes
Usual
9 Ocoupation :
At Home
Industry
10 or Business :
11 Soolal Security No.
None
Jamaica Plain Hass.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings:
Of operations.
Date of
Underline the cause to which death should be charged sta-
tistically.
What test confirmed dlagnosis?
20 Was disease or injury in any way related to oooupation of deceased ?
15 MAIDEN NAME
OF MOTHER
Adeline Reynolds
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston Mass.
17 informant. (Address)
.... A ... Eaton Rgation, if on)
DATE OF BURIAL
March ... 16/48
22 NAME OF
Robert Bell
FUNERAL DIRECTOR
ADDRESS
Brookline ass.
.19
DATE FILED
(Registrar of city or town where death occurred) March 18 .. 19
48
Received and filed. APR 29 1943
(Registrar of City 'or Town where deceased resided)
50m-(b)-6-44-14607
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-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Germany
Of autopsy
Clinical finding
No
if so, specify.
F Murphy
(Signed)
M. D.
(Address)
Glenside aspt
Date
3-13 -- 48
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Forest Hills Cremation
(Cemetery)
(City PasHuy1
19
A TRUE COPY. .
ATTEST La
€
18 DATE OF
DEATH
March 13/48
58 If married, widowed, or dlvoroed
HUSBAND of
(Giy maidenAna par gife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve years
Due to.
Generalized arteriosclerosis
Yrs
Due to.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER
Anton Mosman
5 SINGLE
(write the word)
(If U. S.
War Veteran,
speolfy WAR)
Winthrop Mass.
(Usual place of abode)
Length of stay: In hospital or institution.
(Before death)
(Specify whether)
St.
No.
Boston
CERTIFICATE OF DEATH
(City or Town)
Glenside Hospital
...
years
1
months 26
days.
In this community
yrs.
3 AM
m.
X
M R-302
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
50m-(b)-6-44-14607
17
Informant.
Edith ... Salmon
Batighter
(Address)
88 Winthrop St Winthrop
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED March 22, 19 48
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March
13.
1948
(Month)
(Day)
(Year)
19.
19 I HEREBY CERTIFY,
Mar. 8
That I attended deceased
from
to
Mar .....
13
48
! last saw h ............ allve on.
Mar ...
13
1944g, death is said to
have occurred on the date stated above, at 11:45P.
.m.
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that fact here.
8
AGE.
66 Years.
Months.
..... Days
If less than 1 day
Hours .....
Minutes
Usual
9 Ocoupation :
Housewife
Industry
10 or Business:
Own Home
11 Social Security No ..
None
12 BIRTHPLACE (City)
(State or country)
England
Major findings:
Of operations
Date of
Physician Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased ?.
No
If so, specify
(Signed)
Joseph ... Gregorie
M. , D.
48
(Address)
200 Washington Date : 3/159
Arlington Cemetery
Lington ..... V.a.
DATE OF BURIAL
March 17
1948
22 NAME OF
FUNERAL DIRECTOR
Howard .... S ....... Reynolds
ADDRESS
Winthrop , ..... Mas.s ...
Received and filed APR 151948 19
(Registrar of City or Town where deceased resided)
X
1
PLACE OF DEATH
Suffolk (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
REVERE
(City or town making return)
Registered No.
6.6
No. Revere General Hospital
St.
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME
Edith S. Salmon (Deverell)
(If U. S.
War Veteran,
spoolfy WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
88 Winthrop
SŁ
Winthrop, Mass.
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.Hospital
-
months
7
In this community / yrs. - mos. "
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
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
(Give maiden name Tihon
(Husband's name in full)
Immedlate cause of death
Bronchopneumonia
(Terminal)
2 days
Due to.
Cerebrovascular
accident
6 days
Due to ..
arteriosclerosis
generalized ....... Hypertension
essential
years
Other conditions
(Include pregnancy within 3 months of death)
13 NAME OF
FATHER
Francis Deverell
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Annie Atterton
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ..
(Cemetery)
icity or Town)
Duration
Female
Revere (City or Town)
CERTIFICATE OF DEATH
M R-302
Worcester (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Westborough
(City or town making return)
1
-
(City or Town)
No. Westborough State Hospital
give ite NAME instead of etreet and number)
2 FULL NAME
Christopher Stephenson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
St.
Winthrop.
Mass
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
years
6
months
29
days.
In this community
yrs.
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
March 17 1948
(Month)
(Day)
(Year)
9 | HEREBY CERTIFY, March 22
That I attended deceased from
19 47
to
March 17
19.48
I last saw him.
...... allve on.
March 17,, 1948, death Is said to
have occurred on the date stated above,
4:00 p.m.
Duration
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that faot here.
8
AGE
84
Year
4
Months.
1
Days
If less than 1 day .Hours. Minutes Due to.
Usual
9 Occupation :
Glazier
Industry 10 or Business :
11 Social Security No ....
12 BIRTHPLACE (City)
(State or country)
Ireland
13 NAME OF
FATHER
Richard Stephenson
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Buttler
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Westborough State
Relation, if any
Informant (Address) Hospital records
A TRUE COPY.
ATTEST :
Annell a. Dunne
DATE FILED
(Registrar of city or town where death occurred)
March 31
19.48
Reoelved and filed APR 1 31943
19
(Registrar of City or Town where deceased resided)
(City or Town
19
DATE OF BURIAL
22 NAME OF
FUNERAL DIRECTOR
Irving W. Harper
ADDRESS
Westboro, Mass.
tietically.
What test confirmed diagnosis ?
Clinical Findings
20 Was disease or Injury In any way related to oooupation of deceased ?
If so, speolfy.
Lee W. Darrah
(Signed)
(Address)
Westboro, Mass .
Date
3-17
M. D.
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop, Winthrop
(Cemetery)
March
19
Physician
Major findings:
Of operations
none
Date of
Underline the cause to which death should be charged sta-
50m-(b) -6-44-14607
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-308 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
PLACE OF DEATH
Westborough
Registered No.
62
(If death occurred in a hospital or institution,
St.
(If U. S.
War Veteran,
speolfy WAR)
3 SEX male
4 COLOR OR RACE
white
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED single
5a If married, widowed, or divoroed
HUSBAND of
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