USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 14
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
M R-302 1
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) 11-51-905807
5
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
(City or town making return)
Registered No.
2266 48
J(If death occurred in a hospital or institution. give its NAME instead of street and number)
2 FULL NAME. BETTY .... JANE .... ALU.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
23 Woodside Ave.
Hinthr
St
x
(If nonresident, give
chy of 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
March
5
1953
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
1/30
19
to.
3/5
1953
have occurred on the date stated above, at9 :1.5.a ..
.m. INTERVAL BE- TWEEN ONSET ANO DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
Years
1.
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) ... Boston (State or country)
Mass.
17 NAME OF
FATHER Vincent M alu
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Poston
19 MAIDEN NAME OF MOTHER Mary A Marchiafava
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Louis iana
7 NAME OF
FUNERAL DIRECTOR
DiPietro & Vazza
ADDRESS. East Boston
Received and filed.
MAR 20 1953
19
(Registrar of City or Town where deceased resided)
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED.
(write the word)
ingle
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)
Rickets of renal
origin-congenital
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 clay (Signed). XGH
M.D.
(Address) }.5 St. michael's
6
Place of Burial or Cremation,
(City or Town)
DATE OF BURIAL ar 7
1953
21
Informant.
(Address)
V
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Mar 9
.. 19 ..
53.
-1
Mass.
PARENTS
Date.
3/5
19 53
Boston
No.
Mass General Hospital
(Was deceased a
U. S. War Veteran,
if so specify WAR)
That ?
attended deceased from
I last saw h
.... ex alive on.
3/5
1953, death is said to
RECEIVED
TEV
11 12
1
6
ANTHROP
MARSO FM
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) 11-51-905807
5
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)
2250 49
Registered No. J(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
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)
Winthrop Mass
(a) Residence.
No.
(Usual place of abode)
461 Pleasant St
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.
......
.years ..
3
months. days. In place of residence. ........ .years. months. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(Month)
March 5/53
(Day)
(Year)
8 SEX
F
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
4I HEREBY CERTIFY.
March ... 3
19 ...
53
to
March 5
That
I
attended deceased
from
53
19
19
death is said to
have occurred on the date stated above, at
7;30₽
m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Cerebral hemorrha
3 Day
66
12
AGE
Years
9
21
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
East Poston Mass.
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
Samuel A Snow
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Chatham Mass.
19 MAIDEN NAME
OF MOTHER
Liney E Jones O.K.
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
21
Albert W Jones
Husband
Informant
(Address)
A TRUE COPY
2 Mackie
ATTEST:
(Registrar of City or Town where death occurred)
March 9/53
DATE FILED
19
1
(Registrar of City or Town where deceased resided)
1 Yr
ANTE
CEDENT (b)
CAUSES
Due To
Hypertension
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations
Yes
Date of operation
Was autopsy performed?
What test confirmed diagnosis ?.
clinical ... and lab.
No
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed).
W
S. Karlen
130 Brookline.AVolte
3-5
53
19
Seaside Cem-Chatham Mass.
6 Place of Burial or Cremation
DATE OF BURIAL
March 9/53
19
7 NAME OF
FUNERAL DIRECTOR
A W Marsh
Winthrop Mass.
ADDRESS
Received and filed ..... APR
19
10a
If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
Albert W Jones
I last saw h ..... er .... alive on.
March 5
53
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
PARENTS
Chatham Mass.
(Address)
(City or Town)
M R-302 -
Beth Israel Hospt. No.
Helen Jones
6
APR=0
ANTE CEDENT (b) CAUSES Major findings: Of operations. (Address) 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, CONDITIONS
SUFFOLK
1 BOSTON (County)
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
(City or town making return)
Registered No2313 50
J(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME GEURGA A SULLIVAN
(If deceased is a married, widowed or divorced woman, give also maiden name.)
28 Thornton Park
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death
......
.years.
.. months.
.2.days. In place of residence.
.. 18 years.
.months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March
6
1953
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
3/4
19
3/6
19.53
I last saw h ..... ... alive on
1953., death is said to
have occurred on the date stated above, at 83.03 ....... .. m. INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADINGcerebral thrombosis-2duys2
TO DEATH (a)
11 IF STILLBORN, enter that fact here.
AGE.5P .... Years.
Months1.6
... Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
Paper Hanger
(Kind of work done during most of working life)
14 Industry
or Business:
Self employed
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
Charlestown
17 NAME OF
FATHER
Daniel J Sullivan
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston
Hass
19 MAIDEN NAME
OF MOTHER
Mary Barnes
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Doston
Mass
21 Informant.
(Address)
VAHospital Records
7 NAME OF
FUNERAL DIRECTOR
J Vincent Murray
ADDRESS
Rovere, Maes.
Received and filed
6-1953
19
(Registrar of City or Town where deceased resided)
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
inglo
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
Due To hypertensive çar- diovascular .d.18 -... ense
lyr.
Due To (c)
OTHER
SIGNIFICANT acutemyocardial
infarction
1wk.
Date of operation
Was autopsy performed ?.
.yes
What test confirmed diagnosis?
autopay
5 Was disease or injury in any way related to occupation of deceased?
If so, specify ..
(Signed)
B Kemble
no
M. D.
Date 3/6 1953
6 Holy Cross. Com Place of Burial or Cremation (City or Town) DATE OF BURIAL Mar 9 153
Malden, Mask.
25M.(B)-11-51-905807
3
PLACE OF DEATH
M R-302 1
T.
No. Veterans Administration Hospital St.
(Was deceased a U. S. War Veteran, if so specify WAR).
?aty tom and State)
to ......
3/5
That
I
attended deceased from
PARENTS
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Mar 10
.19 ......
53
DATE OF ENTERING MILITARY SERVICE - 10/4/17 DATE OF DISCHARGE 5/15/19 RANK, RATING SERVICE NUMBER
320 FA U S Army 1914419
RECEIVEO
11 12
1
3
APR-C
X
PLACE OF DEATH
1 SUFFOL! 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)
51
f(If death occurred in a hospital or institution, ul give its NAME instead of street and number)
2 FULL NAME. ALBERT .... BINDMIAN
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
49 Moore
St.
(If nonresidente
r con and state)
Length of stay: In place of death ..
.......
.. years ........
.. months ......?.... days. In place of residence. 35 ... years ..
... months ..
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March
11 ........
1953
(Month)
(Day)
(Year)
4I HEREBY CERTIFY.
That I attended deceased from
3/4
19
to
...
3/11
19
53
10a If married, widowed, or divorced
HUSBAND of.
Jennie Lipofsl
maiden name of wild in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE56 ..... Years ..
Months
Days
If under 24 hours
.. Hours ....
Minutes
ANTE
Due To
CEDENT (b) .carcinoma ... of pancreas
CAUSES
1 yr.
13 Usual
Occupation :.
PRftof Work done during most of working life)
14 Industry
or Business:
Compton Drug Co.
15 Social Security N
024-05-9034
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
Wolf Bindman
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
Rose
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21
Informant
(Address)
VAH Records
7 NAME OF
FUNERAL DIRECTORtanetsky ..... Funeral ..... ChapelA TRUE COPY
ADDRESS Dorchester
Received and filed
19
(Registrar of City or Town where deceased resided)
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDigrried
I last saw h. 1.m ..... alive on.
3. 11
19.53 death is said to
have occurred on the date stated above, at7 :50a.
INTERVAL BE-
m.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a).retroperitoneal .... and .. intraperitoneal hemorrhage
TWEEN ONSET AND DEATH
14hrs
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
carcinoma .... o.f ..... panc.reqs.
Date of operation.
3/10/53.
.Was autopsy performed ?. .y.e.s
What test confirmed diagnosis?
autopsy
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed) ....... Frank
(Address) ..... V.AH
M. D.
Date
3/11
19 .. 53
6 Mt. Lebannon-Kapegorad
Place of Burial or Cremation
" ROZ (City of Town)
DATE OF BURIAL
Mar ..... 12
1953
B Birnbach
ATTEST:
Charles it Mackie
(Registrar of City or Town where death occurred)
Mar
16
53
DATE FILED
19
0
25M-(B)-11-51-905807
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, Sec. 12, G. L.)
1 R-302 -
No. Veterans .... Administration.Hospital
XX
Registered No. 2450
(Was deceased a
U. S. War Veteran,
if so specify WAR)
WE I
no
DATE OF ENTERING MILITARY SERVICE - 1/31/17 DATE OF DISCHARGE 8/16/20 RANK, RATING
Pfc ORGANIZATION & OUTFIT SERVICE NUMBER
U S Army
876 898
ROOMIVA.
3.
jis
6
APR-8
1 R-301A 1
(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.
52
Community tospetal No.
J(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).
33 Grampian Way Dorchester mass
(If nonresident, give city or town and State)
Length of stay: In place of death ... years. 3 .days. In place of residence // ... years . . . months .. days. .months.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March
(Month)
15 (Day) ,
1953 (Year)
4 I HEREBY CERTIFY.
That I attended deceased from
March 11
19.
53.
to ..
march 15.
I last saw h &/ .alive on.
hoved 15, 1953, death is said to
have occurred on the date stated above, at
3:15 A. m.
INTERVAL BE- TWEEN ONSET AND DEATH
3 years
12 AGEC Tea
Months ..
Days
If under 24 hours
Hours
. Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
Home
15 Social Security No. ..
16 BIRTHPLACE (City) Gali Mask (State of country))
17 NAME OF FATHER Mirale Lennon
18 BIRTHPLACE OF FATHER (City) (State or country)*
NewHampshire
19 MAIDEN NAME OF MOTHER
20 BIRTHPLACE OF MOTHER (City) (State or country)
Boston Mars.
21
DATE OF BURIAL 195 3 Informant (Address) CélineCount Meachat
7 NAME OF FUNERAL DIRECTOR)
ADDRESS
Received and filed.
WAR 16 1953
19
(Registrar)
2 years
Due To (c)
PAROtid TUMOR
Loff wine parotid temas
10 years
Major findings:
Of operations
ko
Date of operation
.Was autopsy performed ?..
What test confirmed diagnosis? Clinical + laboratory
5 Was disease or injury in any way related to occupation of deceased ?...
If so, specify.
.....
(Signed) Mayte Transfer
(Address) [ For theday Se Winthrop
M. D.
March 15,1053
Calvary
6
Place of Burial or Cremation
(City or Town)
1%
50M (B)-1-51 903586
C
PLACE OF DEATH
2 FULL NAMI E Imus maud Lennon
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure, asthenia, ns the disease. cations which th
d conditions. ing rise to the e (a) stating lying cause
tions contrib- death but not he disease or ausing death.
PARENTS
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter S. Baking Y
{Signature of Agent of Board of Health or other Seattle Officer (Official Designation) (Date of Issue of Permit)
3.16.53
8 SEX
8 COLOR OR RACE
10 SINGLE
Write the word)
MARRIED
WIDOWED
or DIVORCED COLL-
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.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
disease
ANTE
Due To
CEDENT (b)
CAUSES
JEALIN
OTHER
SIGNIFICANT
CONDITIONS
with left facial paralys,
Registered No.
DisTEN
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, froin 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 cert fying 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,-Ghap. 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 froni 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.isito be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap! 1142See .: 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing xukt df ractirer
(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 frathh Quế when the certificate of death is needed.
3H 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 porsons) 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
R-301A K.
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
To be filed for burial permit with Board of Health or its Agent.
53
Registered No.
J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME
Thomas Francis Carty
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
79 Summit Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .years. months days. In place of residence .O. .years .. months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March 16, 1953
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Feb1 19
53
to ..
march 16
I last saw h. La.alive on
March 16, 1953, death is said to
10:26 A. m.
have occurred on the date stated above, at ..
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a)
acute Coronary thrombin
1 month
12
AGE 75 .. Ye
Months
Days
If under 24 hours
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