USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 32
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
(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
PLACE OF DEATH
Sulfall ( County )
34/13/1 ESKIE
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be hled for burial permit with Board of Health or its Agent.
Registered No.
105
(City or Town)?
80 Chester are Nureticolo No. Milton & Healthy 2 FULL NAME
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) .
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years. months. 3 days.
In place of residence 5 years. months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Mcdowell
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 70 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:
Wooden Bay Construction
15 Social Security No. ..
16 BIRTHPLACE (City) ..
(State or country)
Nova Scotia Halago
17 NAME OF
FATHER
Thenry T tantey
PARENTS
18 BIRTHPLACE OF
FATHER (City){
(State or country)
Parti Dufferinet alfay Co
Hana Scotia
19 MAIDEN NAME
OF MOTHER
Hannah Itaway
20 BIRTHPLACE OF Mora Saateas MOTHER (City) West Lucoddy Hablar Ce
21 Informant (Address)"
Jau Althea Donoghue Sochetter que "Kulturop.
7 NAME OF
FUNERAL DIRECTOR
ADDRESS 210. Илитор И Импергор
Received and filed MAY 8 1953
19
(Registrar)
2 years
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation.
.. Was autopsy performed ?.
Clinical+ Laboratory
ko
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? ...
If so, spedify ...
(Signed) R. Traunstein
M. D.
(Address) 5 2 pherey , W/a Bail 5/57
(City or Towpy
-
6 Place of Burial or Cremation
DATE OF BURIAL 25
100M-(D)-10-48-24656
-301A 1
TIONS TIFICATE ng DEATH nter n one each and (c)
not mean ying, such , asthenia, he disease. ns which
onditions, rise to the 1) stating 1g cause
contrib- th but not disease or ing death.
4 I HEREBY CERTIFY.
That I attended deceased from
Feb 4, 19 53
to
MAY 5
1953
I last saw hkalive on
MAY S, 1953, death is said to
have occurred on the date stated above, at. 4:14P.m.
DISEASE OR CONDITION
DIRECTLY LEADINGY
TO DEATH (a)
"Acute CORONARY
THROMBOSIS
ANTE
Due To
Rheumatic heat
CEDENT (b)
CAUSES
disease
INTERVAL BE- TWEEN ONSET AND DEATH 1/2 ks.
3 DATE OF
DEATH
MAY
(Month)
5
1953
(Year)
(Day) /
(If deceased is a married, widowed or divorced woman/give also maiden name.) 46 Naven St Levere
(a) Residence. No. (Usual place of abode)
I HEREBY CERTIFY that a satisfactory standard certificate of death was
filed with me BEFORE the burial or transit permit was issued:
Walter Af- faker
(Signature of Agent of Board of Health or other)
Health Officer
5. 4.53
(Official Designation) (Date of Issue of Permit)
Carpenter.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged. insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is
caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; . . General Laws, Chap. 38, Sec.6.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held. or from a person appointed to have the care of the cemetery or bumal ground in which the interment is made.
CKap. 114, Sc, 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 phytictan's will certify to such deaths only as those of persons to whom they have en bedside care during a last illness from disease unrelated to any form of inj (2) Board 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 itsAV These include not only deaths caused directly or indirectly by traumatisrh (Including resultingt 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
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.)
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
ost
(City or town making return)
1.08
Registered No.
4347
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME.
Charlotte.Dowling
(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.
55.Foore St.
(Usual place of abode)
St.
(If nonresident, give thy of town and State)
Length of stay: In place of death
......
.. years.
... months. ..... .. days. In place of residence. .... years. months days.
25
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(Month)
May 6/52
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
1953
to.
May ·6. ......
......
153
I last saw h ...
er
.. alive on
May.6 .... 195.3., death is said to
have occurred on the date stated above, at.
INTERVAL BE-
1,56pm.
TWEEN ONSET
AND DEATH
11 IF STILLBORN, enter that fact here.
12
AG:43
.. Years
Months.
Days
If under 24 hours
Hours.
.Minutes
13 Usual
Occupation:
(Kind of work dogs-dung
ing most of working life)
14 Industry
or Business:
15 Social Security No.
Own Home
16 BIRTHPLACE (City)
(State or country)
Presque Isle Maine
17 NAME OF
FATHER
Angus Wilson
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
19 MAIDEN NAME
OF MOTHER
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Cannot be learned
21
Informant
(Address)
E I Deuline
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
May 11/53
19
(Registrar of City qr Town where deceased resided)
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED_
(write the word)
Harriot
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Rob Husband's Dans In full
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Ruptured ... esophageal
varix
36 Hrs
ANTE
Due To
CEDENT (b)
CAUSES
"Laennec's cirrhosis
8 Mos
Due To (c)
-
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
None
Date of operation.
.Was autopsy performed?
Yes
What test confirmed diagnosis ?.
autopsy
5 Was disease or injury in any way related to occupation of deceased?
If so. specify
(Signed).
M. D.
(Address)
L Lezer
.. Date. 19.513
6
Place of Burial direnduson Com-Wintheupor rows . DATE OF BURIAL May 9/53 19
7 NAME OF
FUNERAL DIRECTOR
J F O'Mal ey
Winthrop Mass .
ADDRESS.
MAY 2-2 1953
Received and filed
19
PARENTS
- - ---
Mass.General Host
25M-(B)-11-51-905807
L
M R-302 1
No. .Josg. General. .. Hos.pt.
MEDICAL CERTIFICATE OF DEATH
RECEIVEO
TOW.
OF
11.16. 1
1
5
MAY22 AM
..
..
Jurisdiction waived by Med Examinff Commonwealth of Massachusetts
BOSTON
(City or town making return)
4434
107
¡(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME. Hrry.Rudyin ... orHarry Rudpinsky (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)
29.Ocean Avo
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years.
months8hrs
In place of residence ..
40years.
months.
... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widowed
4 I HEREBY CERTIFY,
That I attended deceased from
May ....
7
19.53.,
to.
Ma.y .....?..
....
19 ..
53
I last saw h ...... malive on ..
.. M.a.y. ..... 7 ........... 1953, death is said to
have occurred on the date stated above. at. 11 .. 35p.m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
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 ... 6.7 .. Years
.Months
Days
If under 24 hours
Hours ......
Minutes
ANTE
CEDENT (b)
Due To
Coronary .... artery
disease
5 yrs
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation
Was autopsy performed ?.... yes
What test confirmed diagnosis?
Autopsy
5 Was disease or injury in any way related to occupation of deceased ?.... no If so, specify.
(Signed).
(Address)330 Brookline Av. Date .....
5/7
153
6 Tiverith Israel of Winthrop Place of Burial or Crematie City or Town) Everett Mass DATE OF BURIAL May ... 10 1953
21
Informant
(Address)
Miriam Korins
7 NAME OF
FUNERAL DIRECTOR.
B .... Birnbach
ADDRESS
Boston Mass
Received and filed.
MAY 2 5 1953
19
(Registrar of City or Town where deceased resided)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
Goldie --
20 BIRTHPLACE OF
MOTHER (City) ... Ru.s.s.i.a
(State or country)
25M-(B)-11-51-905807
X
M R-302 1
PLACE OF DEATH
: SUFFOLK
(City or Town)
No. ..
Beth Israel Hospital
......
EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
Registered No. ......
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
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) .... Acute myocardial infarction
5 days
13 Usual
Occupation:
Salesman
(Kind of work done during most of working life)
14 Industry
or Business:
Tires
15 Social Security No.
16 BIRTHPLACE (City) ...
(State or country)
Russia
17 NAME OF
FATHER
Samuel Rudginsky
S .... L.Katz M. D.
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
May 12
19 53
1
3 DATE OF
DEATH
May 7, 1953
(Month)
(Day)
(Year)
RECEIVEO
OF
11 12. 1
2.
1.10
3
6
THEO
MAY25
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.)
×
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
Bosta
(City or town making return)
Registered No.
414103
J(If death ' occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME George Thurston (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.
23 ... Tewksbury
St.
Winthrop Mass
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death.
.years ..
........
months.28 .... days. In place of residence .?........ years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
May 8/53
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That
attended deceased from
10a If married, widowed, or divorced
HUSBAND of
Mabel .... Johnson
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Bronchio pnoumia
11 IF STILLBORN, enter that fact here.
12
Few DaysE.Q .. . ... Years .......... Month&
Days
If under 24 hours
Hours .....
Minutes
CEDENT (b)
Cormary occlusion
CAUSES
Od and
14 Industry
or Business:
Real Estate
Due To
(c)
Coronary ... arteriosclerosis
Yrs
16 BIRTHPLACE (City).
(State or country)
Uxbridge Mass.
OTHER
SIGNIFICANT
CONDITIONS
Cholelithiasis duli
9 Ya
Major findings:
Of operations.
None
Date of operation
Was autopsy performed ?... Ycs ..
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so. specify.
(Signed)
C.L .Clay
M. D.
(Address)
Mass, General Hos Date.
5-8 1953
6
Place of Burial or Cren
Winthrop Com-Winthrop Mass. (City or Town)
DATE OF BURIAL
May11/53
19
21
Informant
(Address)
Mabel Thurston
7 NAME OF
FUNERAL DIRECTOR
H S Reynolds
Winthrop Mass.
ADDRESS
Received and filed
MAY 2.2 1953
.19
(Registrar of City or Town where deceased resided)
PARENTS
17 NAME OF FATHER
George Thurston
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Maine
19 MAIDEN NAME
OF MOTHER
Eliza Dutton
20 BIRTHPLACE OF
MOTHER (City)
Maine
(State or country)
A TRUE COPY
ArTEST les 21 Mackie
(Registrar of City or Town where death occurred)
May 11/53
DATE FILED
19
MARRIED
WIDOWED arriel
or DIVORCED
April 109 53
May 8, 1953
I last saw h .. i.m .... alive on ..
May8
19 ... 5.3 death is said to
have occurred on the date stated above, at
3:334
.. m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
ANTE
Due To
13 Usual
Occupation:
Broker
(Kind of work done during most of working life)
recen t
15 Social Security No.
034-18-3017
25M .(B)-11-51-905807
1
M R-302 1
Mass.General Hos pt. No.
RECEIVED
TOW
11 12
13-15
1.3
6
HROP.
MAY 22 AM
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
PLACE OF DEATH
SUFFOLK 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)
109
Registered No.
4519
§(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
2 FULL NAME
Margaret Blanchard
(Was deceased a
U. S. War Veteran.
if so specify WAR)
-
(a) Residence. No.
(Usual place of abode)
97 .Washington .Ave
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years ...
.. months ..
6
.days.
In place of residence.
35years
.. months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
May 9, 1953
(Month)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
4 I HEREBY CERTIFY,
That I attended deceased from
May 3
19
53
to.
May .... 9
1953
I last saw h ...... e.M.alive on
May ..... 9 .... , 19.53 death is said to
have occurred on the date stated above, at ... 8 :. 40p
.m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
.
12
AGE6.9
Years
.. Months
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation:
Home
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No.
16 BIRTHPLACE (City) Malden Mass (State or country)
Congestion liver, lungs
term
Major findings:
Of operations
Date of operation
Was autopsy performed ?.
.v.e.s
What test confirmed diagnosis ?.
Autopsy
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
VMGasa
M. D.
(Address) P Bent Brig Hosp Date 5/10
153
6
Winthrop Cem winthrop& 8mm) Place of Burial or Cremation
DATE OF BURIAL
May 13
1953
7 NAME OF
FUNERAL DIRECTOR
.......
W.M .Kirby
ADDRESS
Winthrop Mass
Received and filed.
MAY 201053
19
(Registrar of City or Town where deceased resided)
PARENTS
17 NAME OF
FATHER
William P Powers
18 BIRTHPLACE OF
FATHER (City) .... Conn.
(State or country)
19 MAIDEN NAME
OF MOTHER
Annie Clancey
20 BIRTHPLACE OF
MOTHER (City)
England
(State or country)
21
Informant
Mrs M Donnelly
(Address)
A TRUE COPY
A Tescharles 2. Mackie
(Registrar of City or Town where death occurred)
DATE FILED
.......
May 14 53
1
3-11 Y
A R-302 1
No.
PeterBont Brigham Hosp
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Day)
(Year)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
George A Blanchard
(Husband's name in full)
DISEASE OR CONDITREute anterio
DIRECTLY LEADING
septal myocardial
TO DEATH (a)
n
farction with rupture
into p ricardial space and
hamppericardium
ANTE
CEDENT (b)
CAUSES
Hypertension
1 wk
5 yrs
Due To
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.