Town of Winthrop : Record of Deaths 1949, Part 47

Author: Winthrop (Mass.)
Publication date: 1949
Publisher:
Number of Pages: 456


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1949 > Part 47


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).


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


(a) Residence.


No.


67 Prospect Ave.


St.


Winthrop, Mass.


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death


2 years 1


months2.7


.days. In place of residence


5


years.


months


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


Sept.


6


1949


(Month)


(Day)


(Year)


8 SEX


Female


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED Single


4 I HEREBY CERTIFY,


That I attended deceased from


Sept. 18


47


19


Sept. 6


. 19.4.9,


death is said to


have occurred on the date stated above, at : 30 P. .m.


INTERVAL BE-


10a If married, widowed, or divorced


HUSBAND of.


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Chronic Interstitial


Nephritis


1 year


ANTE


CEDENT (b)


Due To


Uremia


days


13 Usual


Occupation:


Dressmaker


(Kind of work done during most of working life)


14 Industry


or Business:


Self


15 Social Security No.


None


16 BIRTHPLACE (City).


(State or country)


Maine


OTHER


SIGNIFICANT


CONDITIONS


Arteriosclerosis


5 years


Major findings:


Of operations.


None


Date of operation.


None


Was autopsy performed ?.


No


What test confirmed diagnosis? clinical & laboratory


5 Was disease or injury in any way related to occupation of deceased ?. If so, specify.


(Signed)


Jacob J. Abrams


MIR.


6 Woodlawn Crematory !


Everett


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


Sept. 8


19.4.9


7 NAME OF


FUNERAL DIRECTOR


Howard S. Reynolds


ADDRESS


Winthrop Mass.


Received and filed


OCT 11 1949


19


(Registrar of City or Town where deceased resided)


PARENTS


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Unable to obtain


19 MAIDEN NAME


OF MOTHER


Sarah Perce


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Maine


Lincoln Hatch


21


Informant


(Address)


5 Hillside Ave., Winthrop


A TRUE COPY.


ATTEST:


..........


(Registrar of City of Town where death occurred)


DATE FILED


September 14, 1,49


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time 50m-(e)-10-48-24658 after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible CAUSES


ORM R-302 1


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


REVERE


(City or town making return)


COPY OF CERTIFICATE OF DEATH


Registered No.


151


No.


to


Sept. 6


1949


I last saw h.er ...... alive on


TWEEN ONSET AND DEATH


11 IF STILLBORN. enter that fact here.


12


AGE9.5


Years


Months.


Days


If under 24 hours


Hours.


Minutes


Due To


(c)


Senility


1 year


17 NAME OF


FATHER


George Hatch


NO


(Address)


562 Shirley, St. Date


9/7


19.491


9 COLOR OR RACE


(Was deceased a


U. S. War Veteran.


if so specify WAR)


ORM R-302 1


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


No.


2 FULL NAME


3 DATE OF


DEATH


ANTE


Due To


(c)


OTHER


SIGNIFICANT


CONDITIONS


Date of operation


What test confirmed diagnosis?


(Address).


6


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time


after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


of death should be transmitted on Form R-302 to the clerk of the city of town in which the deceased resided as soon as possible


CAUSES


ribs


50m-(e)-10-48-24658


Sept. 9/49


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY.


August


6


19


49


to


Sept. 9


19


49


I last saw h .. im .... alive on


Sept.9


19 ..


149, death is said to


have occurred on the date stated above, at


4:50A


.m.


INTERVAL BE-


TWEEN ONSET


AND DEATH


11 IF STILLBORN, enter that fact here.


51


10


12


AGE


Years


Months


Days


If under 24 hours


Hours.


Minutes


13 Usual


Occupation:


Clerk


(Kind of work done during most of working life)


14 Industry


or Business:


Boston & Maine R.R.


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Revere Mass.


17 NAME OF


FATHER


James A Latter


18 BIRTHPLACE OF


Prince Edward Island Can.


FATHER (City)


(State or country)


dinERAIDEN NAME


OF MOTHER


Anna Broderick


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Canada


Winthrop Vem-Winthrop Mass.


DATE OF BURIAL


Sept. 12/49


19


7 NAME OF


FUNERAL DIRECTOR


C J Murphy


ADDRESS Everett ... Mass.


Received and filed. .19


(Registrar of City or Town where deceased resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


M


9 COLOR OR RACE


10 SINGLE


(write the word)


MARRIED


WIDOWED


Married


or DIVORCED


10a If married, widowed, or divopena Murphy


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADINGBronchogenic carcinoma


TO DEATH (a)


right lung with metastases


Due To


to brain, adrenals, liver and


CEDENT (b)


4 Mos.


Major findings:


Of operations


Lobotomy.


Thoracotony


5-9-49


5-31-49


Yes


Was autopsy performed?


Clinical , laboratory


and autopsy f


5 Was disease or injury in any way related to occupation of deceased? If so, specify.


(Signed)


G & Denny


M.


West Roxbury VAHte


9-9 19.


Place of Burial or Cremation


(City or Town)


-


21


Hospt Records VAH


Informant


(Address)


West Roxbury Mass.


A TRUE COPY


: Michael Mann


ATTEST:


(Registrar of City of Town where death occurred)


Sept. 14/49


DATE FILED


Boston


(City or town making return)


Registered No.


7666


152


death occurred in a hospital or institution.


West Roxbury Massi . St. Į give its NAME instead of street and number)


Alfred S Latter C 1 794 649


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


1


387 Revere


St.


(Was deceased a


U. S. War Veteran, W W #1


if so specify WAR)


Winthrop Mass.


(a) Residence.


No.


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death.


.years.


1


.months.


3.days. In place of residence.


51 years.


months


days.


PLACE OF DEATH


Suffolk (County)


Boston (City or Town)


Veteran's Adm.Hospt


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


CERTIFICATE OF DEATH


MEDICAL CERTIFICATE OF DEATH


That I attended deceased


from


PARENTS


19


RECLIVE


OCT1860N


Entered Service 6-3-18 Discharged 9-30-21 A. S. Radioman U.S.N.


RM R-302 1


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible


Y


PLACE OF DEATH


Suffolk (County)


Revere


(City or Town)


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


REVERE


(City or town making return)


Registered No.


153


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


2 FULL NAME.


Mary A. Brooks


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


69 Almont


1


St.


Winthrop


(If nonresident, give city or town and State)


Length of stay: In place of death


.. years.


1


months.


.. days. In place of residence ..... O .. years.


.. months.


... days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


Sept.


21


1949


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased


from


Aug ..... 21


49


19


to


Sept. 21


19


49


I last saw her ....


... alive on


Sept. 20


1944.9.


death is said to


have occurred on the date stated above, at


12: 25A.m.


INTERVAL BE-


TWEEN ONSET AND DEATH


11 IF STILLBORN, enter that fact here.


12


AGE .. 86 .. Years


Months.


Days


If under 24 hours


Hours ...


Minutes


13 Usual


Occupation:


Cigar Stripper


(Kind of work done during most of working life)


14 Industry


or Business:


cigar


16 BIRTHPLACE (City)


(State or country)


Ireland


17 NAME OF


FATHER


John Brooks


18 BIRTHPLACE OF


FATHER (City) ..


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Catherine Morgan


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


Julia Brooks


21 Informant. (Address) 31 Cross St. Winthrop


A TRUE COPY.


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED September 27, 1, 49


50m-(e)-10-48-24658


6


Calvary


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


Sept. 23


1949


7 NAME OF


FUNERAL DIRECTOR


John F O' Maley


Winthrop


ADDRESS.


Received and filed.


OCT 11 1949


19


(Registrar of City or Town where deceased resided)


8 SEX


9 COLOR OR RACE


(write the word)


Female


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


Single


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


General arterio-


sclerosis


ANTE


CEDENT (b)


CAUSES


Due To


Myocarditis


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Major findings:


Of operations.


Date of operation


Was autopsy performed?


What test confirmed diagnosis ?.


5 Was disease or injury in any way related to occupation of deceased? If so, specify.


(Signed).


Charles F. Mahoney


(Address).


9/21 ,49


Boston


15 Social Security No.


PARENTS


.


No.


Resthaven


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(a) Residence.


No.


(Usual place of abode)


1


PLACE OF DEATH


Suffolk. (County)


Winthrop (City or Ton) Infratruclo Hest Horner


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.


151.


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


(a) Residence. No. 81 Washington Ave (Usual place of abode)


St.


(If nonresident, give city or town and State)


Length of stay: In place of death years. 1 months .days. In place of residence 40


years .months .. days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


October (Month)


1, (Day)


1949 (Year)


4 [ HEREBY CERTIFY,


That I attended deceased


from


Ceny 15


19 45.


to ..


Certi,


I last saw h. I'm alive on.


19.4 9 death is said to


have occurred on the date stated above, at f.1).P.m.


INTERVAL BE- TWEEN ONSET AND DEATH 3 years


11 IF STILLBORN. enter that fact here.


12 AGE77 Years


Months . Days


If under 24 hours


Hours


.Minutes


13 Usual


Occupatotired


(Kind of work done during most of working life)


14 Industry


or Business :.


Wholesale Meat


15 Social Security No.


16 BIRTHPLACE (City). (State or country) England


17 NAME OF


FATHER


John Benson


PARENTS


18 BIRTHPLACE OF


FATHER (City)


(State or country)


England


19 MAIDEN NAME OF MOTHER Martha Walker


20 BIRTHPLACE OF MOTHER (City) (State or country) England


21 Informant Sadie A. Benson


(Address) 81 Washington Ave


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


Walter et- Marek


(Signature of Agent of Board of Health or other) Health Miricle 10 g, 49


(Official Designation)


(Date of Issue of Permit)


100M-(D)-10-46-24666


Received and filed.


OCT 4 1949


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX Male Thite


9 COLOR OR RACE


10 SINGLE


MARRIED


WIDOWED


or DIVORCEDried


(write the word)


10a If married, widowed, or divorced HUSBAND of. Sadie .. .. A


Clark


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


ANTE Due To CEDENT (b) CAUSES


Due To (c) ..


OTHER


SIGNIFICANT Chronic Arthritis


CONDITIONS


Major findings:


Of operations.


20000


Date of operation


Was autopsy performed? Clinical Signs


5 Was disease or injury in any way related to occupation of deceased ?.


If so, specify ...


Daniel 2. 0/ Run


(Signed)


(Address)


M. D.


Winthrop , mass Date


Cct, 3 1945


6 Tinthrop


Winthrop (City or Town)


Place of Burial or Cremation DATE OF BURIAL


Oct 4,1949


19


7 NAME OF


FUNERAL DIRECTOR


ADDRESS


John HO Maley Winthrop


Registered No.


[(If death occurred in a hospital or institution.


.. St. [ give its NAME instead of street and number)


PHYSICIAN - IMPORTANT -


(Was deceased a U. S. War Veteran, ( if so specify WAR)


RUCTIONS FOR L CERTIFICATE


giving OF DEATH not enter than one for each (b) and (c)


does not mean of dying, such ilure. asthenia, ans the disease, ications which ath.


bid conditions. ring rise to the se (a) stating erlying cause


itions contrib -- e death but not the disease or causing death.


M R-301A 1


Y


What test confirmed diagnosis?


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 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 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 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 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 registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall 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. 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 persons 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 follow- ing 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 physician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposably 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.


· Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. 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


RM R-302 1


PLACE OF DEATH


Suffolk (County)


Boston


(City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


Boston


(City or town making return)


Registered No.


8297


155


2 FULL NAME


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


24 Temple Ave.'


Winthrop Mass.


(a) Residence. No. (Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death


.years


2


.months


8


25


days. In place of residence.


.. years


months


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


Oct. 1/49


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY. Aug. 23 19. 49


That


I attended


Oct. 1


19


deceased


from


49


I last saw


h


im alive on


Oct/1


19.


49


death is said to


10a If married, widowed, or divorcelva Mccarthy


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE


79 Years.


Months


.. Days


If under 24 hours


.Hours . . ... Minutes


Salesman 13 Usual Plugupation: (Kind of work done during most of working life)


14 Industry


or Business:


Department Store


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Boston Mass ..


OTHER SIGNIFICANT CONDITIONS


Major findings:


Of operations.


1.Cecostomy 8-26-49


2. Resection of colon


9-21-49


Date of operation.


Was autopsy performed ?. Yes


What test confirmed diagnosis?


autopsy


5 Was disease or injury in any way related to occupation of deceased? If so, specify.


(Signed)


J.S. Lichty


M. D.


(Address)


Mass.General Hosphate. . 10-2


19 49


Holyhood-Brookline Mass.


Place of Burial or Cremation (City or Town)


DATE OF BURIAL Oct.5/19


19


7 NAME OF


FUNERAL DIRECTOR


Winthrop Mass.


ADDRESS


Received and filed.


NOV 1 1949


19


(Registrar of City or Town where deceased resided)


PARENTS


17 NAME OF FATHER Michael Wells


18 BIRTHPLACE OF


FATHER (City).


(State or country)


Boston Mass.


19 MAIDEN NAME


OF MOTHER


Johana A


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Boston Mass.


E Mccarthy


A TRUE COPY


ATTEST:


(Registrar of City or Town where death occurred) Oct. 6/49


DATE FILED


.19


(write the word)


8 SEX


M


9 COLOR OR RACE


W


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


Married


have occurred on the date stated above, at 9;20₽ .m. INTERVAL BE- TWEEN ONSET AND DEATH 24 Hrs


DISEASE OR CONDITION DIRECTLY LEADINPeritonitis, pelvic TO DEATH (a)


Due To


Perforation of cecum


ANTE


CEDENT


(b)


spontaneous


24 Hrs


Due To


Carcinoma of colon


(c)


1 Yr.


6 Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12. G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible CAUSES 50m-(e)-10-48-24658


No.


Mass. General Hospt.


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


John Wells


(Was deceased a


U. S. War Veteran,


if so specify WAR)


St.


COPY OF CERTIFICATE OF DEATH


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


21


Informant.


( Address)


M w Kirby


to


RECEIVEO


-IT


11 1,2


:1-10


INTHRO


NOV-11349 AM


×


PLACE OF DEATH


Suffolk (County)


Winthrop (City of Town) 15 Prescott 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 Agent.


156


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


PHYSICIAN - IMPORTANT


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


15 Prescott St


St.


(If nonresident, give city or town and State)


Length of stay: In place of death years months.


days. In place of residence. 4 . . years


.. months .days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


act-


(Month)


2


(Day)-


1949 (Yeaf) /


8 SEX


9 COLOR OR RACE


Thite


10 SINGLE


MARRIED


WIDOWED


OMDIYORFERI


(write the word)


4 I HEREBY CERTIFY,


9-1-


I last saw h


.alive on 9-30-19 % death is said to


have occurred on the date stated above. at


À m.


INTERVAL BE- TWEEN ONSET AND DEATH 7-1


11 IF STILLBORN, enter that fact here.


12


AGE


Months


Days


If under 24 hours


Hours ..


... Minutes


13 Usual


Occupation :


Police Officer


(Kind of work done during most of working life)


14 Industry


or Business:


Police


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Ea.s.t. B.o.s.t.o.n


Mass


17 NAME OF FATHER Dennis Murphy


PARENTS


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Mary A. Daly


20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland


21 Informant Hanoria ... Murphy


(Address) 15 Prescott St


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:




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