USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 95
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75 | Part 76 | Part 77 | Part 78 | Part 79 | Part 80 | Part 81 | Part 82 | Part 83 | Part 84 | Part 85 | Part 86 | Part 87 | Part 88 | Part 89 | Part 90 | Part 91 | Part 92 | Part 93 | Part 94 | Part 95 | Part 96 | Part 97 | Part 98 | Part 99 | Part 100 | Part 101 | Part 102 | Part 103 | Part 104
419a Revere St.Winthrop
A TRUE COPY. ATTEST: Joseph d. yrett.
(Registrar of City or Town where death occurred)
DATE FILED
Nov.16,1951
19
25m-(h)-10-48-24658
3 DATE OF DEATH Injury Nature of (Address) 7 Place of Burial, or Cremation. 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 Injury quickly of death should be transmitted on Form R-305 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.)
PERSONAL AND STATISTICAL PARTICULARS
(Was deceased a U. S. War Veteran,
(write the word)
Restaurantour
Restaurant
OF TO!
11 19
1
6)} in)
VIN'
5
6
MAGE
P
DEC111951 AM .
R-302 1
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.
269
Revere Memorial Hospital
J (If death occurred in a hospital or institution,
St. \ give its NAME instead of street and number)
2 FULL NAME
Joseph Wallace
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
No
U. S. War Veteran,
( if so specify WAR)
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In place of death
years
.. months.
days.
In place of residence.
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
November
25
1957
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
November ...... 21 19 ... 51 ...
to.November ..... 25 ...
195.1
I last saw h.i.m ..... alive on November ...... 2519.5.1, death is said to
have occurred on the date stated above.
8:40 A.
.. m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
67
AGE
Years
9
Months.
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation:
Retired - Fireman
(Kind of work done during most of working life)
14 Industry
Boston Fire Dept.
or Business:
15 Social Security No.
015-20-2686
16 BIRTHPLACE (City).
(State or country)
New York
17 NAME OF
FATHER
James Wallace
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Sarah Feenan
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21 Informant (Address)
A TRUE COPY.
(Registrar of City or Town where death occurred)
Received and filed.
DEC 2 : 1951
19
(Registrar of City or Town where deceased resided)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
10a If married, widowed, or divorced
HUSBAND of
Mary .... Monahan
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Coronary Thrombosis
Due To
Arteriosclerotic
Duodenal Ulcer
5 Yrs
5 Was disease or injury in any way related to occupation of deceased ?.... N.Q. If so, specify ....
(Signed)
William W. Dorfman
M. D.
Date 11/25/1951
Winthrop
6 ... Winthrop Place of Burial or Cremation (City or Town)
DATE OF BURIAL .. November .... 28 19.5.1
7 NAME OF
FUNERAL DIRECTOR
Michael J. Porcella
ADDRESS
876 Minthonor Ary., Revere, MasATTEST:
31 hours
45 minutes
3 years
No.
146 Bowdoin
(a) Residence. No.
(Usual place of abode)
(Month)
(Day)
ANTE
CEDENT (b)
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation
(Address)
Revere, .... Mass ...
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
Heart Disease
50m-(e)-10-48-24658
4 day
Was autopsy performed?
What test confirmed diagnosis ?.
Phys . Exam.
PARENTS
DATE FILED
November 27,
19.
51
302
1
Revere
CERTIFICATE OF DEATH
Registered No.
No. Revere .... Memorial .... Hospital ........ ........
J(If death occurred in a hospital or institution,
St. [ .give its NAME instead of street and number)
2 FULL NAME
Aurore .... Legere
(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. 104 Highland Avenue
St.
Winthrop
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death
.years ..
9
months.
days. In place of residence
35 .. years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
November
27
1951
(Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
4 I HEREBY CERTIFY,
That I attended deceased from
February
19.5.1 .....
to .. November ..... 27, 19.5.1.
I last saw h ...... Aralive on .. November.27, 19 .. 5] death is said to
have occurred on the date stated above, at1: 10 .... P.m.
INTERVAL BE-
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Alderic Legere
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
P. Imonary Edema
TWEEN ONSET AND DEATH 1 Day
11 IF STILLBORN, enter that fact here.
12
AGE 2
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.
16 BIRTHPLACE (City)
(State or country)
Canada
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation
Was autopsy performed ?..... No
What test confirmed diagnosis ?.
X-ray & Clinical
5 Was disease or injury in any way related to occupation of deceased ?. NO. If so, specify
(Signed)
William A. Saccone
M. D.
(Address) 732 .... Broadway
Rove Patel 1/27/ 1951
Malden
6 .Holy Cross
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
November 30,
19.5.
7 NAME OF
FUNERAL DIRECTOR
J. Vincent Murray
Revere
ADDRESS
Received and filed
DEC 2 0 1951
19
(Registrar of City or Town where deceased resided)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
19 MAIDEN NAME
OF MOTHER
C.B.L.
20 BIRTHPLACE OF C .B.L. MOTHER (City) (State or country)
21 Charles Legere
Informant
(Address)
112 Walnut St. , Saugus
A TRUE COPY.
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
December 10,
19 51
50m-(e)-10-48-24658
PLACE OF DEATH
Suffolk (County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
REVERE
(City or town making return) 230
of death should be transmitted on Form K-502 to the clerk of the city of 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.)
ANTE CEDENT (b)
Due To
Intestinal
CAUSES
Obstruction
1 Mo
Due To
(c)
Due to Carcinoma
of Bowel
17 NAME OF
FATHER
Charles Legere
NO
(Month)
(Day)
1
PLACE OF DEATH
Worcester (County)
RUTLAND
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
RUTLAND
(City or town making return)
271
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME .. John Robert Magoe
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
150Horman St
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In place of death .....
.years.
-months.
23days.
In place of residence .. .......... years. months. .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
0
COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased
from
Aug .... 7 ,
1951
to ..
Nov . 30,
19
51
I last saw
.im .... alive on
Nov .30
19.5.1 death is said to
have occurred on the date stated above, at.
10.30 pm
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Pulmonary tuberculosis
3yrs
Due To
CEDENT (b)
CAUSES
Due To
(c)
OTHER
SIGNIFICANT
Tuberculous empyema
Date of operation.
Was autopsy performed ?.
What test confirmed diagnosis ?.
X-ray, Laboratory
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed) George Altonhaus
M. D
(Address) Rutland Mass. DatNov. 30 19 ....
Winthrop, Mass.
6 Winthrop Com. : Place of Burial or Cremation (City or Town)
DATE OF BURIAL December ..... 4. 19 51
21
Informant
(Address)
Put.Winthrop
7 NAME OF FUNERAL DIRECTOR Charles H.Trosnor
ADDRESS
726 Saratoga St. ,E.Boston, MagsTEST:
Received and filed DEC 1 /1951 19
(Registrar of City or Town where deceased resided)
PARENTS
17 NAME OF FATHER
18 BIRTHPLACE OF
James J. Magee
FATHER (City)
Boston,
(State or country)
19 MAIDEN NAME
OF MOTHER
Elizabeth Henton
20 BIRTHPLACE OF
MOTHER (City)
Boston,
(State or country)
Mass
A TRUE COPY
Lunda a Hanff
(Registrar of City or Town where death occurred)
DATE FILED
December1
07
.. 19
Single
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.22 ... Years.
.. 4 ..... Months .... ] .. '3.Days
If under 24 hours
Hours .......
Minutes
13 Usual
Occupation:
Truck driver
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No ..
022-20-4740
16 BIRTHPLACE (City)
(State or country)
Chelsea, Mass.
3 DATE OF
DEATH
ANTE
Major findings:
Of operations.
Copies of retums of deaths which occurred in your city of town in case the deceased resided in another city of town at the time
CONDITIONS
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 (E)-6-50.902253
after the close of the month in which the death occurred. (See Chap. 46, Ser 12, G. L.)
-302
1
No. Rutland .... StatoSanatorium
Registered No.
(Was deceased a
U. S. War Veteran,
if so specify WAR).
November 30, 1951
05 TOP
11 17
8
INT
6
HR
DEC1 71951 AM
-
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) 29 James Ave .
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.
222
[(If death occurred in a hospital or institution, Bt. [ give its NAME instead of street and number)
2 FULL NAME ..
Anna Agnes (Conley) Robbs (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)
(a) Residence. No. (Usual place of abode)
29 James Ave.
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
3 DATE OF
DEATH
December
5, 195I
(Day)
(Month)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Octig 19
48
to
Dec 1
1951
I last saw her
alive on
Dec 1
. 19 SI death is said to
have occurred on the date stated above, at
12:30 P.m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
immediate Years
I8
12
AGEGI
9
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:
Own Home
15 Social Security No. .
16 BIRTHPLACE (City)
Boston
(State or country)
Massachusetts
17 NAME OF
FATHER
Denis Conley
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Mary Donley
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21 Tirs. Evelyn Johnson
Informant (Address) 29 James Ave, Winthrop, g
FUNERAL DIRECTOR.
ADDRESS ICO Winthrop St. Winthrop
Received and filed DEC. 1.0. 1951 19
(Registrar)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED Widow~
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Paul Temple Robbs
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Coronary occlusion
Due To
arterial hypertension
ANTE CEDENT (b) CAUSES Congestive heart failure
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? no
If so, specify.
(Signed) H . B.
(Address) H41 Shirley It winthrop ate 1 7-6
1951
M. D.
Winthrop, Mass
Winthrop Cemetery, 6 Place of Burial or Cremation
(City or Town)
DATE OF BURIAL December , 7
7 NAME OF
Victoria a. Reynolds
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burinhor transit permit was issued: Watter & Hookers. (Signature of Ageht of Board of flealth or other) Health officer 1275
(Official Designation) (Date of Issue of Perdut)
/
-301A 1
IONS TIFICATE ng DEATH nter n one each nd (c)
not mean ing. such asthenia, he disease. ns which
nditions. ise to the ) stating cause
contrib- h but not isease or ng death.
50M (a)-1.51 903586
death.
20
Registered No.
No.
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 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 disahled 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
Suffolk (County)
Boston
(City or Town)
Mass. Memorial Hospital
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF TEM CERTIFICATE OF DEATH
Boston
(City or town making return) 10828
Registered No.
273
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME George Chandler
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 40 Washington Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.
.......... years.
months 23
days.
In place of residence.
40.years
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Dec.6/51
(Month)
(Day)
(Year)
attended deceased from
4 I HEREBY CERTIFY, Nov ..... 13, 19 51
That
Dec.6
51
I last saw h
im alive on
19:
death is said to
have occurred on the date stated above, at
8;55A
m.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Gastro intestinal
hemorrhage
1 Day
12
AGE
63
Years
Months.
Days
If under 24 hours
Hours ..
Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
17 NAME OF FATHER George Chandler
18 BIRTHPLACE OF
Boston Mass.
FATHER (City).
(State or country)
19 MAIDEN NAME
OF MOTHER
Anna Lally
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Winthrop Cem Winthrop Mass
Place of Burial or Cremation
Dec. 10/51
19
DATE OF BURIAL
Maurice W Kirby
7 NAME OF
FUNERAL DIRECTOR
Winthrop Mass ..
ADDRESS
Received and filed.
DEC 2 4 1951 19
(Registrar of City or Town where deceased resided)
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
10a If married, widowed, or dipose A Curley
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
ANTE
CEDENT (b)
CAUSES
Due To
Uremia
6 Mos
Due To
(c)
Chronic nephrosclerosis
OTHER
SIGNIFICANT
CONDITIONS
Hypertension
4-5 Y 9
Major findings:
Of operations.
Date of operation
Was autopsy performed? Yes
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
G .Entwisle
Mass. Mem . Hosp.t.
.Date. 12-6 51
19
6
(City or Town)
21 Informant (Address)
Mrs Rose Chandler
ATTEST:
arles H. Macker
(Registrar of City or Town where death occurred)
DATE FILED
Dec. 11/51 ········ .. 19 ..
-
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 after the close of the month in which the death occurred. (See Chap. 46, Ser 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
R-302 1
No.
-
(Was deceased a
U. S. War Veteran,
if son specify WAR)
Winthrop
as's.
(Usual place of abode)
to.
Dec.6
51
19
Salesman
Boston Mass.
PARENTS
(Address)
03
TO
11 72
8
4
6
ASS
HROP
DEC241951 AM
U
X
PLACE OF DEATH
Suffolk (County)
Winthrop (City of Town)
lesce
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
274
j(If death occurred in a hospital or institution,
No. Mounts Conv Home-104 Highland Avenuest. ( give its NAME instead of street and number)
2 FULL NAME. Bertha Lubin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
U. S. War Veteran,
( if so specify WAR)
(a) Residence. No.
140 ..... Shirley
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
years 2 months
25 a
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.