USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 100
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Ireland
21 Informant (Address) 63 Terrace Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or tramit permit was issued:
Walter & Kaker
1.0 (Offidal Designation)
Dec. 17/3/
(Date of Issue of Permit)
TRUCTIONS FOR L CERTIFICATE
giving : OF DEATH not enter e than one e for each , (b) and (c)
s does not mean e of dying, such failure. asthenia, eans the disease, lications which cath.
bid conditions, iving rise to the use (a) stating lerlying cause
ditions contrib- he death but not the disease or causing death.
50m-(b)-11-49-920,569
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
(write the word)
10a If married, widowed, or divorced
HUSBAND of .. .
Anna . Malone
(Give maiden name of wife in full)
have occurred on the date stated above. at
3.A.m.
INTERVAL BE-
TO DEATH
ANTE
CEDENT (b)
CAUSES
Due To
Due To (c) ..
OTHER SIGNIFICANT CONDITIONS
18 BIRTHPLACE OF FATHER (City) (State or country) Ireland
0.
Mary Brannan
M R-301A 1
2 Basto. 1/7/52
No. Winthrop
Community
191 to Nie ii
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 shallexhume 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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. ... - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4. Acts of 1945.
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
7
PLACE OF DEATH
Essex
(County) Da vers
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
Danvers
(City or town making return)
Registered No.
234
CERTIFICATE OF DEATH
(City or Town) Danvers State hospital, Hathorne No. Albert Berry
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death. ......... .years.
months. 4 .days. In place of residence. ....... .. years. .months. .. days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Widowed
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
Dec. 13,
51
2
19
to ..
Dec. 13,
57
19 death is said to
have occurred on the date stated above, at.
INTERVAL BE-
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
years
12
AGE
Years
Months
23
Days
If under 24 hours
Hours ..
Minutes
13 Usual
Retired Caretaker
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No. Unknown
16 BIRTHPLACE (City)
(State or country)
Canada
17 NAME OF
FATHER
18 BIRTHPLACE OF
Cannot be learned
FATHER (City) (State or country)
19 MAIDEN NAME
OF MOTHER
Cannot be learn d
20 BIRTHPLACE OF MOTHER (City) (State or country)
Cannot be lined
21 Mary E. Sheehan
Informant. (Address)
H thorne, Ters
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred) Decemb
1
,
19
(Registrar of City or Town where deceased resided)
years
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings: Of operations
.Was autopsy performed ?. 0
Date of operation Lab. & Clinical
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? if so, specify ..... Andrew Nichols 3rd. (Signed) Danvers, dass
12/19/ M. 93 (Address) Date .... winthrop detery
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL
December 51
19
7 NAME OF FUNERAL DIRECTOR Winthrop, Lass.
Howard S. Reynolds
ADDRESS
Received and filed. JAN : 1952 19
in trop
25M (E)-6.50.902253
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 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 after the close of the month in which the death occurred. (See Chap. 46, Ser 12, G. L.)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
December 17, 1951
19 51
I last saw h
alive on
10:15 Pm
10a If married, widgited, or divortdh Woodland HUSBAND of. (Give maiden name of wife in full)
(or) WIFE of
TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADINGArteriosclerotic heart TO DEATH (a)
disease
ANTE CEDENT (b) CAUSES
Due To Generalized Arteriqsclerosi Occupation:
Annapolis Valley, N. S
Comist be learned
PARENTS
That I attended deceased from Dec. 17,
7
1 R-302 1
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Winthrop
St.
DATE FILED
88.
2
RECEIVE O
OFFIC
8
5
THRO
JAN-9 AM
ORM R-306
N.B .- WRITE PLAINLY WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information should be carefully supplied. AGE should be stated EXACTLY. See reverse side for affidavit.
Winthrop copy-LEEd APR. 110, 1952
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
15 MAIDEN NAME
OF MOTHER
Angela Matarozza
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
17 Informant (Address)
Relation, if any (
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
(Official Designation)
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December 17, 1951
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
19
_, to.
., 19
I last saw h
alive on
, 19
, death is said
to have occurred on the date stated above, at
m.
Duration
years
Immediate cause of death
Cardio renal
disease; acute cholecystitis with pupture and bile
Due to
peritonitis.
Oper.
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Physician Underline the cause to which death
Of autopsy
What test confirmed diagnosis?
should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify
(Signed)
M W O'Connell
M. D.
(Address)
Date
19
21
Holy Cross Cem Malden Mass
Dec 28ty or Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL.
19
22 NAME OF FUNERAL DIRECTOR ADDRESS
Received and fled.
Dec 20
19.51
A TRUE COPY ATTEST:
(Registrar)
1
(City or Town)
No.
Boston City Hosp
St.,
Ward
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Lorenzo Marotta
(If deceased is a married, widowed or divorced woman, give also maiden name.)
specify WAR)
(a) Residence. No.
(Usual place of abodc)
98 Ocean View St
St.,
.Ward,
Winthrop Mass
(If nonresident give city or town and state)
Length of stay: In hospital or institution (Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE| 5 SINGLE
White
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
66
AGE
Years.
Months.
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Industry
10 or Business:
Laborer
11 Social Security No.
12 BIRTHPLACE (City)
Italy
(State or country)
13 NAME OF
FATHER
Lorenzo Marotta
20m.(a)-6-'40-3181
PLACE OF DEATH
(County)
BOE
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS AFFIDAVIT AND CORRECTION OF A RECORD OF DEATH
#47
tawn making return)
284.A
Registered No.
1111
(If U. S.
War Veteran, no
Maria Vitiello
MARGIN RESERVED FOR BINDING
DEPOSITION WRITE LEGIBLY WITH DURABLE BLACK INK
The Commonwealth of Massachusetts
ss. :
County of ......... Suffolk
The undersigned, being duly sworn, depose and say that the record relating to the death
of. ...... Lorenzo Marotta in the. City of BOSTON
(Give name of decedent exactly as recorded on the original record) (City or town) (Name of city or town)
does not fully and correctly state all the facts relating to said death, and that the true statement of
facts omitted or incorrectly stated in said record has been supplied by. her .. on the
(Him or her)
form of certificate on the other side of this blank.
SIGNATURE
RESIDENCE
(City or town, street and number, if any)
Relation to decedent,
if any
Frances L Marotta
98 Ocean View St
Daughter
Winthrop
...
FURTHER, The written evidence submitted to substantiate the affidavit was:
Incorrect address at time: father became ill while visiting relative. Correct address Winthrop town clerk certificates filed Date, ............ Ma ....... 24, .... 1.952
Then personally appeared before me the person whose signature appear above and made oath that the statements subscribed to by her are true.
Name Mary Manning ......
........
Official designation .... NP
(City or town clerk or assistant clerk)
MARGIN RESERVED FOR BINDING
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, Ser 12, G. L.)
PLACE OF DEATH
Suffolk
(County)
Boston
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
11076
285
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Ella.R Torrey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
783 Shirley
St
St.
(Was deceased a
U. S. War Veteran,
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.
4
.years
1
months
13
days.
In place of residence.
......... years ...
.months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Dec.17/51
8 SEX
F
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
4 I HEREBY CERTIFY,
Nov. 4 19.
47
to
That
I attended deceased from
Dec.17
5.
19
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)
Arterio sclerotic heart
disease
4 Yrs
86
11
12
AGE.
Years
Months
Days
25
If under 24 hours
.. Hours ...
.Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
None
16 BIRTHPLACE (City)
(State or country)
Newton Mass.
17 NAME OF
FATHER
William H Park
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Lowell Mass.
Was autopsy performed ?.
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased ?. No
If so, specify. Ruth M Crc rossfield
(Signed)
(Address)
6 Parley Vale Date
12-17 19 ..
First Parish Cem-Norwell Mass.
6 Place of Burial or Cremation (City of Town)
DATE OF BURIAL
Dec.19/51
19
21 Informant ( Address)
Mimarles H. mackie
(Registrar of City or Town where death occurred) Dec.19/51
DATE FILED
19
(Registrar of City or Town where deceased resided)
PPARENTS
19 MAIDEN NAME
OF MOTHER
Eliza Hand
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston Mass.
P Grogan
Atty.
7 NAME OF
FUNERAL DIRECTOR
J L Wadsworth
Norwell Mass.
ADDRESS
Received and filed JAN 7 1952 19
4 Yrs
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation.
History and clinical exam
Over
ANTE
Due To
CEDENT (b)
General.arterio
sclerosis
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
(Month)
(Day)
(Year)
I last saw h
eralive on
Dec/17/51
19
death is said to
Howard C Torrey
have occurred on the date stated above. at
9$15A
m.
INTERVAL BE-
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 25M (E).6.50.902253
R-302 1
No. . Glenside Hospital
A TRUE COPY
M. D.
+
PLACE OF DEATH
Suffolk (County)
Boston
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CTEN CERTIFICATE OF DEATH
Boaton (City or town making return)
11143
Registered No.
286
[(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Esther Sedoff
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 212 Shore Drive (Usual place of abode)
......
St.
Winthrop Mass.
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years.
months.
days.
In place of residence.
30 .. years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Dec. 17 19
51
to
Dec .. 18
1951
I last saw h ........... alive on
Dec. 18
19 ...
5-death is said to
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Samuel Sedoff
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
Arterio sclerotic
heart disease
6 Mos. 64
12
AGE
Years
Months.
Days
If under 24 hours
Hours .....
Minutes
13 Usual
Occupation:
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
At Home
15 Social Security No.
None
16 BIRTHPLACE (City).
(State or country)
Russia
17 NAME OF FATHER Bernard Itzkowitz
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
Baile
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify .. L Lezer
(Address)
Lebanon Cem-Peabody Mass.
6
Place of Burial or Cremation
Dec. 19/51
19
(City or Town)
DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
H Torf
ADDRESS
Chelsea Mass.
Received and filed. JAN / 1952 19
(Registrar of City or Town where deceased resided)
PARENTS
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
Isaac Malkin
21
Informant
(Address)
A TRUB COPY
ATTESTELes & Imackie
(Registrar of City or Town where death occurred)
DATE FILED
Dec.20/51
19
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 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, Ser 12, G. L.)
25M (E).6.50.902253
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings: Of operations.
Date of operation
None
(Signed)
Mass.Gen, Hospt ...
Date ..
12=18
19
.Was autopsy performed?
Yes
What test confirmed diagnosis?
autopsy
11 IF STILLBORN, enter that fact here.
3 DATE OF
DEATH
Dec. 18/51
Widowed
have occurred on the date stated above, at
2;55A
.. m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
1 R-302 1
Mass. General Hospital No.
(Was deceased a
U. S. War Veteran,
if so specify WAR)
f PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No. 287
52 Grand View Avenue No.
[(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR)
NO.
(a) Residence. No. 52 Grand View Avenue
. ... St.
(If nonresident, give city or town and State)
Length of stay: In place of death years ... .. months. .days. In place of residence .. years
months .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWEDmarried
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
Sept
19/7.
to
Dec. 2+19,
1951
I last saw her alive on.
Dec.
19
195%, death is said to
have occurred on the date stated above, at 4:45- A
.m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) aromary Occlusione
15 min.
ANTE
Due To
CEDENT (b)
CAUSES
Due fol
arrifana irles
Petites, ademina
Gatrestam Idenonce
OTHER
SIGNIFICANT
CONDITIONS
(acromegaly) aempire, yo.
Major findings:
Of operations
Date of operation. .
Was autopsy performed?
What test confirmed diagnosis?
5 Was discase or injury in any way related to occupation of deceased?
no
(Signed)
diferençané
M. D.
(Address)
200 Washingtonpare Date 12-20
190%
Winthrop Cemetery Winthrop) Place of Burial Er Cremation
DATE OF BURIAL December 21.1951
19
7 NAME OF
FUNERAL DIRECTOR
Refund B. March
ADDRESS
174 Winthrop St, Winthrop, Mass.
Received and filed DEC 21 1951 .19
(Registrar)
11 IF STILLBORN, enter that fact here.
12
65
AGE
Years
5Months
15 Days
If under 24 hours
Hours . .. Minutes
13 Usual
Occupation :
housework (Kind of work done during most of working life)
14 Industry or Business: own home
15 Social Security No ..
none
16 BIRTHPLACE (City)
(State or country)
Massachusetts
17 NAME OF FATHER Aaron Slutzki
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
Rose Minski
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Poland
21 Informant Samuel L. Cohen (Address) 52 Grand View Ave, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Waller . (Signature of Agent of Board of Health or other) Health Officer 12/21/51 (Official Designation)
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