USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 93
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death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical; thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap414 Sec. 46, G. L., (Tercentenary Edition).
EIV ERULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice: Attending physicians will certify to such deaths only as those of persons to whom they hare given bedside care during a last illness from disease unrelated to any form of injury. Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of have died without recent medical attendance or whose physician is absent ome when the certificate of death is needed.
Medical Examiners will investigate and certify to all deaths supposably due to intitu !! These include not only deaths caused directly or indirectly by
trauc ton (hclutling, resulting septicemia), and by the action of chemical (drugs or poicane) 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
· 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
RM R-302 1
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
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,
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)
10724
275
Registered No.
Hospt . 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.) 90 Read St
Winthr off Meggy WAR)
(a) Residence. No.
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
years
1
months.
7
days. In place of residence
.years
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Dec. 10/54
8 SEX
M
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Mar'r tedord)
1 (Month)
(Day)
(Year)
4I HEREBY CERTIFY.
Nov. 3
54
19
to.
19
10a If married, widowed, or divorcehna Maglio
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).
Hodgkin's Disease
TWEEN ONSET
AND DEATH
Appr
4 Yrs
11 IF STILLBORN, enter that fact here.
12
AGE
31
Years
9
20
If under 24 hours
Hours ........ Minutes
Major Appliance
13 Usual
Occupation:
(Kind of work done during most of working life)
14 Industry
or Business:
Salesman Jordan Marsh
Co.
15 Social Security No.
023-16-9067
16 BIRTHPLACE (City).
(State or country)
Revere Mass.
17 NAME OF
FATHER
Dominic Petronio
18 BIRTHPLACE OF
FATHER (City)
(State or country)
---- Unknown
19 MAIDEN NAME
OF MOTHER
Josephine Luongo
20 BIRTHPLACE OF
Boston Mass.
21 Informant Mr ...... A ... Petronio.
(Address)
7 NAME OF
FUNERAL DIRECTOR
Paul Buonfiglio
Revere Mass.
ADDRESS.
Received and filed.
JAN 24.1955
19
(Registrar of City or Town where deceased resided)
PARENTS
5 Was disease or injury in any way related to occupation of deceased? If so, specify Roger B Hickler
(Address)
(Signed)
VAH Boston Mass Date
12-10
5%
19 ...
MOTHER (City)
(State or country)
Oak Grove Cem-Medford Mass.
6 Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
Dec. 13/54
19
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Dec/1.51511
19
.......
25M-10-53-910021
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 ?..
pathological ... exam.
Na
That
deceased
fren
I last saw h.
im
Dec10
alive on
19 ..
death is said to
have occurred on the date stated above, at.
10;20A
.m.
INTERVAL BE-
22
(Was deceased a
U. S. War Veteran,
w W #11
No.
Veteran's
George G Petronio
M. S.
Months.
Days
RECEIVED
OF TOWN
OFFICE
11 72
In
NIN
CLERK
5
6
ASS
----
JAN2& AM
Entered Service 7-26-1943 Discharged 2-13-46 US Army Service No. 31369072
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.)
25M-5-52-907046
X
Essex
(County)
Danvers
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Danvers
(City or town making return)
Registered No.
276
Da vers State Hospital No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Lena Michael (Fleischer)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
18 Dolphin Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .....
.years
2 months ..
23 days.
In place of residence ..
.....
.years.
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
December 11, 1954
(Month)
(Day)
(Year)
4I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.)
11a If married, widowed, or divorced
HUSBAND of
Henrycin rehaen
[ wife in full)
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
68
AGE
Years
-
Months.
.Days
If under 24 hours
.. Hours
Minutes
14 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
15 Industry
or Business:
16 Social Security No.
17 BIRTHPLACE (City).
(State or country)
Russia
18 NAME OF
FATHER
(Unknown) Fleischer
19 BIRTHPLACE OF
FATHER (City).
(State or country)
Russia
20 MAIDEN NAME
OF MOTHER
Cannot be learned
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
22
Informant
(Address)
A TRUE COPY.
FUNERAL DIRECTOR
ADDRESS. Brookline, Mass.
Received and filed.
JAN 1: 1955
19
(Registrar of City or Town where deceased resided)
PARENTS
If so, specify Ralph P. Mccarthy
(Signed)
Peabody, Mass.
Date.
Sharon Memorial Park, Sharon 7
Place of Burial, or Cremation.
December
12
(City or Town)
54
DATE OF BURIAL
8 NAME OF
Henry Levine
M.
(Address)
(Specify type of place)
Manner of
Injury
(How did injury occur?)
Nature of
Injury
While at work?
Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased?
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
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
PLACE OF DEATH
RM R-305 1
Acute Gastroenteritis Arteriosclerotic Heart Disease
5 Accident, suicide, or homicide (specify).
Date and hour of injury. 19
Where did
Injury occur?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place?
10 COLOR OR RACE
11 SINGLE
(write the word)
MARRIED
WIDOWED
Married
or DIVORCED
9 SEX
'''emale
White
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Winthrop
(a) Residence. No.
(Usual place of abode)
2 FULL NAME.
(City or Town)
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
December 20
X
RECEIVES
TOWN
OF
11 12 1
5
6
JAN12
RM R-302 -
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, 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 WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
PLACE OF DEATH
Essex (County)
Danvers (City or Town) No. 73 Centre
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Danvors
(City or town making return)
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)
(a) Residence. No.
18 Jones Ave.
(Usual place of abode)
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In place of death.
........... years.
months .. L.Q .days. In place of residenceLO ...
... years ...
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
$ SEX
Female
9 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
Dec ....... 12.
1954 Dec.
17
¡10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Charles S. Bectlc
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING .
TO DEATH (a)
uvocarditis
11 IF STILLBORN, enter that fact here.
12
AGE.75 Years&.
.. MontÌ
11
Days
If under 24 hours
Hours ... .. Minutes
13 Usual
Occupation:
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No.
16 BIRTHPLACE (CitySomerville,
(State or country)
11953.
17 NAME OF
FATHER
henry 1. Harper
Major findings:
Of operations.
Date of operation
Was autopsy performed ?... 10
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify.
(Signed).
......
Charles ......... Deoring.
M. D.
(Address)
Danvers,
Date 12/17/105/1
6
"DivGini& Cremation
(čky or Towh)
DATE OF BURIAL.
December .... 20
195
7 NAME OF FUNERAL DIRECTOR award . Fonoles
ADDRESS Winthrop. ... Mass.
Received and filed 19
(Registrar of City or Town where deceased resided)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
En-land
19 MAIDEN NAME
OF MOTHER
Emma Fowler
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
In.I. na
21
Informant.
(Address)
13 Contre st., Danvers
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred) V
DATE FILED
December
17
19
54
Due To
Antonio
ANTE
CEDENT (b)
CAUSES
sclerosis
3 yrs
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
hernia
diaphramatic
10 WI
25M-3-53-909098
Plac
Gary .... Rider
idow
I last saw a .......... alive on ... De .............. 7
15, death is said to
have occurred on the date stated above,
11 A.
.m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
10 wk
3 DATE OF
DEATH
December
17, 1954
Alice S. Beetle (Hrrpor))
RECEIVED
OF
TOW:
11 12 1
: : 1.2
3
JAN12
X
SUFFOLA
(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) 11198278
Registered No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Mary Parmelee
(If deceased is a married, widowed or divorced woman, give also maiden name.)
26 Sturges St
St.
Winthrop Moss
(If nonresident, give city or town and State)
Length of stay: In place of death.
.......... years.
months.
4
20
days.
In place of residence
.. years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED arried
4 I HEREBY CERTIFY,
That I attended deceased from
Nov 19 1. 54.
to ..
Dec 23
I last saw h
.Oralive on
Dec .... 23 . 19.54
death is said to
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
Herrall Parmelee
(or) WIFE of.
(Husband's name in full)
TWEEN ONSET
AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
65 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.
Kingston .... NY
16 BIRTHPLACE (City) ..
(State or country)
17 NAME OF
FATHER
Edward O'Hara
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Rhode ..... Island
19 MAIDEN NAME
OF MOTHER
Margaret Clark
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Kingston N Y
Lola Ciampoli
7 NAME OF
FUNERAL DIRECTOR.
M ......... Kirby
ADDRESS WinthropMass
Received and filed.
FTB - 1955
19
(Registrar of City or Town where deceased resided)
PARENTS
Here Af perforated
omInaI.
gastrectomy
Was autopsy performed ?.
clinical
no
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
CL Clay
M. D.
Date 12/23
.19 ... 54
Winthrop Mass
Eity or Town)
Dec .27
19.544
21
Informant
(Address)
A TRUE COPY
copy Charles A. La
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED Dec .... 28 .19 ... 54. X
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
No.
2 FULL NAME.
(a) Residence. No.
(Usual place of abode)
(Month)
DISEASE OR CONDITION
DIRECTLY LEADING
ANTE
CEDENT (b)
CAUSES
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
What test confirmed diagnosis?
(Address)
M.G .H
6
Winthrop Cem
Place of Burial or Cremation
DATE OF BURIAL
25M-3-53-909098
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,
Date o
1275 &30/54
3 DATE OF
DEATH
Dec 23, 1954
(Day)
(Year)
19.54
have occurred on the date stated above, at
3:40 & m.
INTERVAL BE-
TO DEATH (a) ..
Perforation of
carcinoma of stomach
34 ds
6 mos
Due ToCarcinoma of stomach
PLACE OF DEATH
RM R-302 1
Mass General Hosp
(Was deceased a
U. S. War Veteran,
if so specify WAR)
RECEIVED
OF
TOWN
11 12 1
OLE
OFFI
1:11
5
6
THROP
FEB-3 AM
S44
44444
வர் பாடகர் திருவேற்காண்டு
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