Town of Winthrop : Record of Deaths 1951, Part 29

Author: Winthrop (Mass.)
Publication date: 1951
Publisher:
Number of Pages: 614


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 29


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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SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT


SERVICE NUMBER


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


25m-(b)-11-49-900,475


PLACE OF DEATH


Essex (County)


Danvers


(City or Town)


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Danvers


(City or town making return)


71


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


Mass.


2 FULL NAME. LUBELI ...... Never


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


(a) Residence. No. inthron, Mass St.


........ ............


(If nonresident, give city or town and State)


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


.months


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March 2.


1951


(Month)


(Day)


(Year)


8 SEX


Male


9 COLOR OR RACE


white


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


widowed


4 I HEREBY CERTIFY,


Jan. 30


19 51


to .. March 2


19


51


I last saw


h.


im


alive on


March 2,, 19.


19 5 ] death is said to


have occurred on the date stated above, at. 10:00 pm.


INTERVAL BE-


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a).


Bronchopneumonia


TWEEN ONSET AND DEATH 2 da


11 IF STILLBORN, enter that fact here.


AGE 94


Years


Months.


.Days


If under 24 hours


Hours


Minutes


13 Usual


Occupation:


Unable to work


(Kind of work done during most of working life)


14 Industry or Business:


15 Social Security No ..


None


16 BIRTHPLACE (City)


(State or country)


Russia


OTHER


SIGNIFICANT


CONDITIONS


Major findings:


Of operations.


Date of operation.


Was autopsy performed?


No


What test confirmed diagnosis?


Clinical


19 MAIDEN NAME


OF MOTHER


Unknown


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


If so, specify.


cev mitchols 3rd


M. D.


(Signed) ....


(Address) Danvers, Dass. Date


19


. Temple Israel Cemetery


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


liarch


195.1


21


Informant


(Address)


Hathorne, Mass.


7 NAME OF


FUNERAL DIRECTOR


Levine Funeral ServiceTRUE COPY


ADDRESS


Boston ....... Ma.s.s.


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


Larch 9


1957


......


(Registrar of City or Town where deceased resided)


PARENTS


17 NAME OF


FATHER


Unknown


18 BIRTHPLACE OF


FATHER (City)


Unknown


(State or country)


Unknown


Unknown


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Unknown


Takefield


Georgie T. Brimigion


Received and filed.


APR 1 1 1951


19


10a If married, widowed, or divorceunknown 2. Unknown


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


ANTE


Due To


CEDENT (b)


CAUSES


Due To (c)


Unknown


R-302 1


Registered No.


No. Danvers State Hospital, Hathorne


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(Usual place of abode)


That I attended deceased from


RECLIVE.


APR121951 1Y


R-302 1


PLACE OF DEATH


Essex (County)


Danvers (City or Town)


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Danvers.


(City or town making return)


Registered No.


72


No. Danvers .... State .... Hospital. .... Hathorne.


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


2 FULL NAME. GARDINER ....... Edwin .... P.


(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. 11 .... Prospect.


St.


(If nonresident, give city or town and State)


Length of stay: In place of death. ...... .years.


.months 1 .. days. In place of residence. ........ .years


months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March


5


19.5.1


(Month)


(Day)


(Year)


8 SEX


Male


9 COLOR OR RACE


White


10 SINGLE


(write the word)


MARRIED Widowed


WIDOWED


or DIVORCED


4 I HEREBY CERTIFY,


That I attended deceased from


.March 4" 19 .. 51 to March 5 ...


19


50


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


Unknown


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


month&GE .... 76 Years.


Months.


Days


If under 24 hours


.. Hours.


Minutes


13 Usual


Occupation:


Retired .... railroad .... man


(Kind of work done during most of working life)


years


14 Industry or Business:


15 Social Security No.


16 BIRTHPLACE (City) ..


(State or country)


Chelsea


OTHER SIGNIFICANT CONDITIONS


Major findings:


Of operations


Date of operation


Was autopsy performed ?. ...... No


What test confirmed diagnosis ?.


Clinical


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


(Signed). Andrew .Nichols .... 3rd. M. D.


(Address)


Danvers, Mass.


Date 3/8/51 19.


6 Place of Buri der Cremation


Auburn Cemetery Cambridge. (City or Town)


DATE OF BURIAL March 9, 19. 51


Informant (Address)


Georgie .... T ........ Brimigion Hathorne Mass


A TRUEOCOPY


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


........


7 arch


.19


57


(Registrar of City or Town where deceased resided)


PARENTS


18 BIRTHPLACE OF


FATHER (City) (State or country)


Unknown


Mass


19 MAIDEN NAME


OF MOTHER


Adelaide Hyde


20 BIRTHPLACE OF MOTHER (City) (State or country) Lass .Lynn


21


7 NAME OF FUNERAL DIRECTOR J ..... S .Vaterman & Son


ADDRESS Boston ...... Ma.ss ..


Received and filed.


APR 1.1 1951


19


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


25m-(b)-11-49-900,475


ANTE


Due To Malignant .... Hypertension


CEDENT (b) CAUSES


Due To (c)


DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Hypertensive ... heart disease


TWEEN ONSET AND DEATH


I last saw him alive on March 5, 19 .... 5Jdeath is said to have occurred on the date stated above, at 10:40pm. INTERVAL BE-


Winthrop


(Usual place of abode)


J(If death occurred in a hospital or institution,


1


17 NAME OF FATHER Charles L. Gardiner


0


APR111951


+


PLACE OF DEATH


Essex. (county)


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Danvers (City or town making return)


Registered No.


73


St. [ give its NAME instead of street and number) J(If death occurred in a hospital or institution. No. Danvers State Hospital, Hathorne.


2 FULL NAME. (If deceased is a married, widowEd Fa Gud Com) , give also maiden name.)


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(a) Residence. No. $2.Fremont St ...


.......


St.


WintherQin city or town and State)


Length of stay: In place of death. 1.8years .. 2months. &days. In place of residence. ........ years. .months. .days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


March


(Month)


(Day)


1951


8 SEX


Female


9 COLOR OR RACE


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


Single


4 I HEREBY CERTIFY,


That I attended deceased from


April 10 ...


19 ... 50.


to ..


March 8.


19


51


I last saw h ..... p.alive on ..... March ............... 19.5.7, death is said to


10a If married, widowed, or divorced


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 ....... Years.


Months.


Days


If under 24 hours


.Hours ......


.Minutes


13 Usual


Occupation :


most& borking life)


14 Industry or Business:


15 Social Security No .. None


16 BIRTHPLACE (City).


(State or country)


Somerville


Lass.


17 NAME OF


FATHER


John H. Williams


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Lass


Boston


19 MAIDEN NAME OF MOTHER Sarah Bragdon


20 BIRTHPLACE OF MOTHER (City) Boston


(State or country)


Mass.


21 Informant (Address) Mary E. Sheehan


A TRUE COPY


Hathorne, 1995.


ATTEST:


(Registrar of City of Town where death occurred)


DATE FILED


March 12


19 51


(Registrar of City or Town where deceased resided)


weeks


ANTE Due To


CEDENT (b) CAUSES


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Major findings:


Of operations


Date of operation


Was autopsy performed ?. Yes


What test confirmed diagnosis ?.........


Autopgy


5 Was disease or injury in any way related to occupation of deceased? If so, specify (Signed). Andrew Nichols 3rd. M. D.


(Address). Danvers Hass


19.


6


Milton Cemetery ........ Milton, Mass


Place of Burial or Cremation


DATE OF BURIAL March 10


7 NAME OF FUNERAL DIRECTOR Mortimer .N .... ..... Peck


ADDRESS Braintree Lass.


Received and filed APR 1-11951 ..... ...... 19


PARENTS


25m-(b)-11-49-900,475


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, Sec. 12, G. L.)


R-302 1


have occurred on the date stated above, at 12.05 am. INTERVAL BE- TWEEN ONSET AND DEATH


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a).


Bilateral Lung


Abscess


(write the word)


(Usual place of abode)


APR _ _ 1051 /1


F


PLACE OF DEATH


Suffolk


(County)


(City or town making return)


Registered No.


3312.4


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


2 FULL NAME


Anna Gilman


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


(Was deceased a


U. S. War Veteran.


if so specify WAR)


St.


Winthrop


Mass.


(If nonresident, give city or town and State)


Length of stay: In place of death


2


.years


1


months.


days. In place of residence


2 years


1


months.


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


F


9 COLOR OR RACE


W


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


Widow


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


March 1.


19 ..


49


That I


attended deceased


April 3


19


51"


I last saw


h


alive on


19


death is said to


have occurred on the date stated above, at


12:20A


m.


INTERVAL BE- TWEEN ONSET AND DEATH


DISEASE OR CONDITION


DIRECTLY LEADING cute myocardial infarction


TO DEATH (a)


3 Day


12


72


AGE


Years


Months.


.Days


If under 24 hours


Hours


Minutes


13 Usual


Occupation :


Housework


(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


5-6 Yrs


17 NAME OF


FATHER


Rubin Bian


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Russia


Date of operation.


Was autopsy performed?


What test confirmed diagnosis ?.


Examination


NO


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


If so, specify ....


HA Derow


M. D.


(Address)


Boston Mass.


Date. 4-3 19


6


Place of Burial or Cremation DATE OF BURIAL.


April 4/51


19


7 NAME OF


FUNERAL DIRECTOR


A Golov


Dorchester Mass.


ADDRESS


Received and filed. APR 16 1951


19


(Registrar of City or Town where deceased resided)


PARENTS


19 MAIDEN NAME


OF MOTHER


Sarah -


Russia


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


21 Informant (Address)


HebrewHome for Aged


A TRUE COPY


ATTE


Martes H. Inackie


(Registrar of City or Town where death occurred)


DATE FILED


April 6/51


19


R-302 1


Boston


(City or Town)


No.


21 Queen St


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Boston


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, Sec. 12. G. L.)


25m-(b)-11-49-900,475


ANTE Due To Coronary arterio sclerosis


CEDENT (b)


CAUSES


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Senile psychosis


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


Morris Gilman


(or) WIFE of.


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


3 DATE OF


DEATH


April 3/51


(write the word)


(a) Residence. No.


36 Cutter


(Usual place of abode)


to


April 3


51


er


Major findings:


Of operations.


No


(Signed)


Winthrop Cem-Everett Mass.


(City or Town)


<


RM R-301 1


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


Winthrop (City or town making return)


25


42 Harbor View Avenue No.


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


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


(a) Residence. No. . 42 Harbor view Avenue (Usual place of abode)


St.


(If nonresident, give city or town and State)


Length of stay: In place of death. .. years. ..... months. .days. In place of residence.20 ... years. ... months .days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


female


white


10 SINGLE


MARRIED


WIDOWED Widowed


or DIVORCED


4 I HEREBY CERTIFY,


19.


to


19


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


WilliamA ... Williams


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGB60


Years


3 Months 21 Days


If under 24 hours


Hours.


Minutes


13 Usual


Occupation :.


Graphotype Operator


(Kind of work done during most of working life)


14 Industry


or Business: Christian ..... Science ..... Pub .... Co.


15 Social Security No ... 0.1.5-20-08.61


0


16 BIRTHPLACE (City)


Malden


0


(State or country)


Mass.


OTHER


SIGNIFICANT


CONDITIONS


Major findings:


Of operations


Date of operation


Was autopsy performed ?.


no


What test confirmed diagnosis?


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


(Signed) .


(Address) Wanting Board Date 4 abril 951


inthrop


of reality womb


.inthrop


(City or Town)


Place of Burial or Cremation


DATE OF KURAL entombment 4/6/51 19


7 NAME OF


FUNERAL DIRECTOR.


alfred B. Marek


ADDRESS


174 Winthrop St, Winthrop


Received and filed


19


APR 9 .


.1951


(Registrar)


PARENTS


18 BIRTHPLACE OF


FATHER (City).


charlestown


(State or country)


Mass.


ยท


willlow


19 MAIDEN NAME


OF MOTHER


Llano Elwa Williams


20 BIRTHPLACE OF


Charlestown


M. D. MOTHER (City) (State or country) Mass.


21


Informant


Harold F. Robie


(Addr Prospect St, Marshfield,Mass I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


Watter of Bakker (Signature of Agent of Board of Health of other)


Health Oficer (Official Designation) (Date of Issue of Permit)


4/5/51


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 ath.


bid conditions, iring rise to the use (a) stating erlying cause


ditions contrib- he death but not the disease or causing death.


to get there due to road 1.16. When it is fusible.


conditions approximately avril 28, V951


Due To


Presumably


ANTE


CEDENT (b)


CAUSES


Coromant


Due To


Occlusion


(c)


INTERVAL BE- TWEEN ONSET AND DEATH


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a).


Natural causes


I last saw h ...........


alive on 19 death is said to


have occurred on the date stated above, at


about 8 p.m.


3 DATE OF


DEATH


abril


4.


1951


(Year)


9 COLOR OR RACE


(write the word)


(Month)


(Day)


That I attended deceased from


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


NO.


Registered No.


A IRLL COPY ATTEST


17 NAME OF


FATHER


Eugine Field Robie


.


Helen


Cemetery Effingham


-


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 behef 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 imine- diate cause of death as nearly as he ean 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, br (leemed 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 elerk 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 elerk 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 elerk 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 elerk or registrar may require .- Chap. 114, See. 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 medieal 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 elerk 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., (Tereentenary 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 deathsonly 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 oeeupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


Statement of Cause of Death .- Physicians: see explanatory instruetions 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 oceupa- tion had been given up or changed, or it 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 domestie service for wages, however, designate the oeeupation by the appropriate terms, as housekeeper-private family, cook-hotel, ete. 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


PLACE OF DEATH


Winthrop (County) Suffolk (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.


76


J(If death occurred in a hospital or institution. St. { give its NAME instead of street and number) No. Winthrop Community Hospital Annie Elizabeth Riley (If deceased is a married, widowed or divorced woman, give also maiden name.)


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR)


80 Buchanan Street


St. .


(If nonresident, give city or town and State)


Length of stay: In place of death .. years ...


months 2.3 days. In place of residence 32 years


months


days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


abril Month)


6


(Day)


1951 (Year)


8 SEX


Female


9 COLOR OR RACE


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCEMarried


4I HEREBY CERTIFY,


March 1,


er


1951.


to


.alive on


april 6


I last saw h.


That


I


Atended deceased from


abril 6


1257


1957, death is said to


have occurred on the date stated above, at


9:30 A.m.


INTERVAL BE-


TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.


2 weeks


12


78


AGE


Years


Months


Days


If under 24 hours


.. Hours .. .. Minutes


13 Usual


Housewife


4 weeks


Occupation :..




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