Town of Winthrop : Record of Deaths 1957, Part 17

Author: Winthrop (Mass.)
Publication date: 1957
Publisher:
Number of Pages: 566


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 17


Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).


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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


.......


X


Essex


(County) Nahant


(City or Town)


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


Habant


(City or Town making this return)


5


Registered No.


(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.)


28 Palmyra


St


(If nonresident, give city or town and State)


Length of stay: In place of death


2


year


5


months.


.. days. In place of residence


37years


months


.days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


January 16,


1957


DEATH


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY, That I attended deceased from Aug.3 54 Jan. 16


957


I last saw Holalive on J'an. 15 157 death is said to


have occurred on the date stated above, at


3.00 A.


p.m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Acute Myocardial Infarct.


(a)


INTERVAL BETWEEN ONSET AND DEATH 1 hr


Due To


Coronary Sclerosis


5 yrs


13 Usual


Occupation :


Housewife


(Kind of work done during most of working life)


14 Industry


or Business :


At Home


15 Social Security No.


none


16 BIRTHPLACE (City)


(State or country)


Nov .


17 NAME OF


FATHER


Harry Bllomfield


18 BIRTHPLACE OF


FATHER (City) ..


(State or country)


England


19 MAIDEN NAME


Maria Stewart


OF MOTHER


20 BIRTHPLACE OF


Scotland


MOTHER (City)


(State or country)


Edward C. Kemp.


Informant 86 Aspen Avevamoscott


21


(Address)


7 NAME OF


Howard S. Reynold


FUNERAL DIRECTOR Winthrop Mass.


ADDRESS


Received and filed.


MAR 26 1957


19


(Registrar of City or Town where deceased resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR


white


10 SINGLE


MARRIED


WIDOWED ! id OW


or DIVORCED


(write the word)


10a If married, widowed, or divorced HUSBAND of


(Giye maiden name of wife in full)


Benjamin Graham


(or) WIFE of.


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


86


?


24


AGE


Years.


Months.


[Days


If under 24 hours


Hours ........ Minutes


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed ?.


no


What test confirmed diagnosis ?


no


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


Lester H. Tobin


(Signed) ....


84 Humphrey St. Swampscott


M. D.


(Address)


Date. 1/16 19 .... 5.7


inthrop


inthrop Mass


(City or Town)


DATE OF BURIAL


Place of Burial or Cremation Jan. 18, 57 19


50MI.11.55-016145


(b) 6 resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. 1 .. ) Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased


R-302 1


PLACE OF DEATH


271 Nahant Road


No.


Elizabeth (Bloomfield) Graham


(a) Residence. No .. (Usual place of abode)


(Was deceased a


U. S. War Veteran,


if so specify WAR)


Winthrop, Mass.


A TRUE COPY


ATTEST:


(Registrar of City or Town where death occurred)


DAYZ PHED


January 16, 1957 19.


PARENTS


Jersey City


19 to


RECETTE


6


MAR 2 61957 AH


X


Suffolk


(County) Boston


(City or Town)


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


Bostm


(City or Town making this return)


1172


Registered No.


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


Ida Abrams


2 FULL NAME


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


264 River Road


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


Winthrop Mass.


(a) Residence. No. (Usual place of abode)


Length of stay: In place of death ...... ....... year 25 minutes


6 hrs


MEDICAL CERTIFICATE OF DEATH


Feb. 2/57


(Day) (Year)


4 I HEREBY CERTIFY,


Feb.2


57


That I attended deceased from


Feb.2


57


I last saw h. .... alive on 19 2;LopM death is said to have occurred on the date stated ahove, at .m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Diabetic coma


INTERVAL BETWEEN ONSET AND DEATH 4 Hrs


11 Yrs


Due To


Diabetes mellitus


OTHER


Cerebral vascular insufficiency


Yes


Lab.


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


ALikais


M. D


New End . Deaconess Hos pt Date. 19


2-2- 5


(Address) Tifereth Israel Everett Mass


6 Place of Burial or Crematieb. 3/57


DATE OF BURIAL 19


Torf Funeral Service Chelsea Mass.


ADDRESS


Received and filed. MAR 27 1957 19


(Registrar of City or Town where deccascd resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


F


9 COLOR


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married


10a If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Henry Abrams


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE.61.


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 : Own Home


15 Social Security No ..


16 BIRTHPLACE (City)


(State or country)


Russia


17 NAME OF FATHER Abraham Pubin


18 BIRTHPLACE OF


FATHER (City)


(State or country)


19 MAIDEN NAME


OF MOTHER


Gertrude


Russia


MOTHER (City).


(State or country)


21 Informant. (Address)


Henry Abrams 264 River Load Winthrop Mass.


A TRUE COPY Karl


ATTEST:


(Registrar of City or Town where death occurred) Feb. 7/57


DATE FILED


- 19


V.B.V


(a) (b) Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c)


5031 .11.55 916:45


IS.


3 DATE OF DEATH (Month) SIGNIFICANT CONDITIONS Was autopsy performed? (Signed) 7 NAME OF FUNERAL DIRECTOR resided as soon as possible, after the close of the month in which the death occurred. (Sec Chap. 46, Sec. 12, G. L.) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased What test confirmed diagnosis?


R-302 1


PLACE OF DEATH


No.


New England Deaconess Host.


30


(If nonresident, give city or town and State)


months.


days. In place of residence


.years.


months


days.


19


Feb.2


57


19


... ,


PARENTS


Russia


20 BIRTIIPLACE OF


(City or Town)


S


RECEVLY


0.61


5


6.


MAR 2 71957 AM


M R-302 1


PLACE OF DEATH


Essex


(County)


Danvers


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


.Danvers


(City or Town making this return)


Registered No.


§(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.)


(a) Residence. No ...


30 Revere


winthrop, riass.


St


(If nonresident, give city or town and State)


Length of stay: In place of death


years.


3


.months


29


days. In place of residence.


......... years.


months.


.days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


Feb.


10,


1957


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY


That I attended deceased from


Apr.


10,


50


Feb.


10


19


to.


Feb


10,


57


19


death is said to


have occurred on the date stated above, at 8:10 Pm


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


larasmus


· INTERVAL BETWEEN ONSET AND DEATH Vks.


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


White


9 COLOR


10 SINGLE


(write the word)


Single


MARRIED


WIDOWED


or DIVORCED


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


61


8


AGE


Years.


Months.


Days


If under 24 hours


.Hours ........ Minutes


13 Usual


Occupation :


Unable to work


(Kind of work done during most of working life)


14 Industry or Business:


15 Social Security No ...


16 BIRTHPLACE (City)


(State or country)


Hass.


17 NAME OF


FATHER


18 BIRTHPLACE OF


FATHER (City).


(State or country)


Connecticut


19 MAIDEN NAME


Mary Jane MeNalley


OF MOTHER


20 BIRTHPLACE OF


LASS . MOTHER (City).


(State or country)


Mary E. Sheehan


Informant.


(Address)


Hathorno, tass.


7 NAME OF FUNERAL DIRECTOR


Wm. H. Crosby, Inc.


ADDRESS Danvers, Mass.


Received and filed MAR 17 . 19


(Registrar of City or Town where deceased resided)


PARENTS


(Signed)


Andrew Nichols III


M. D.


(Address)


Hathorne, Mass.


Date


2/10


57


19


Dan. State Hosp. Com 6


datiTorno,


(City or Town)


Place of Burial or Cremation March 8,


DATE OF BURIAL 19


57 21


A TRUE COPY


ATTEST:


( Registrar of City or Town where death occurred)


DATE FILED


March 11,


57


19


X


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


(a) Due To (b) .... Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c) resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


What test confirmed diagnosis?


Clinical : Lab.


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


25M-8-56-918227


(City or Town) Danvers State Hospital, Hathorne, No.


Mary Dolan


(Was deceased a


U. S. War Veteran,


No


if so specify WAR)


(Usual place of abode)


21


57


19


I last saw h ........ alive on


Willian d. Dolan


Pennsylvania


TO


...


0


MAR 1 91957 AM


+


PLACE OF DEATH


'SURIOLKI


(County) BOSTON!


(City or Town)


Enroute to Mass


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


EOSTON


(City or town making return)


Registered No.


1597 50


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


Arthur C Totman


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


(Was deceased a


U. S. War Veteran,


if so specify WAR).


sWinthrop ...


Mass


44


(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.


PERSONAL AND STATISTICAL PARTICULARS


9 SEX


M


10 COLOR OR RACE


5


11 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married


11a If marrie


wird a dipenselman Dunbar


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


12 IF STILLBORN. enter that fact here.


13


78


AGE


Years


Months


Days


If under 24 hours


Hours


Minutes


14 Usual


Occupation:


(Kind of work done during most of working life)


15 Industry


Ice Cream & ConfectionaryCo


or Business:


16 Social Security No. Clinton


17 BIRTHPLACE (City)


(State or country)


Me


18 NAME OF Willis Vincent Totman FATHER


PARENTS


19 BIRTHPLACE OF


FATHER (City)


(State or country)


Maine


20 MAIDEN NAME


OF MOTHER


Martha Hunter


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Maine


Wife


22 Informant (Address)


A TRUE COPY


ATTEST:


(Registrir of City or Town where death occurred)


DATE FILED


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


l'eb 18


19 57


-


M R-305 1


No.


2 FULL NAME


(a) Residence.


No.


51 Loring Road


(Usual place of abode)


MEDICAL CERTIFICATE OF DEATH


3 DATE OF February


DEATH


(Month)


(Day)


Fracture of Skull


....


5 Accident, suicide, or homicide (specify).


Accident


Where did


(City or town and State)


place?


Public Highway


Manner of


(Specify type of place)


Injury


Pedestrian .... struck


(How did injury occur?)


Nature of


Injury


by motor car


If so, specify.


(Signed)


M A Luongo


(Address)


Boston


Date.


7


DATE OF BURIAL.


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-305 to the clerk of the city or town in which the deceased resided as soon as possible


Injury occur?


Revere, Mass


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


M. D.


2-141


1957


Winthrop Cem Winthrop


Place of Burial, or Cremation.


(City of Town)


reb 17 .1957


8 NAME OF


FUNERAL DIRECTOR


A B Marsh


ADDRESS Winthrop, Mass


Received and filed APR -3 1957 19


(Registrar of City or Town where deceased resided)


13


1957


(Year)


4 I 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.)


Bilateral Compound Fractures .of


Legs


Date and hour of injury


Feb


.13 ...


.1957


Did injury occur in or about home, on farm, in industrial place, or in public


While at work?


Was autopsy performed?


No


25m-(c)-11-49-900.475


m.S.


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


Retired Owner


RECEIVE


0


5


APR - 91957 AM


R-301A 1


CTIONS R ERTIFICATE Iving F DEATH : enter an one or each ) and (c)


s not mean of dying, art failure, . It means or compli- ich caused


, if any, je rise to (a). he under- last. use


ns contrib- ath but not the terminal dition given


Chapter 137, 54, requires to print or cause or death on


ificates.


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town))


yostore 4-8457


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD


To be filled for burial permit with Board of Health or its Agent.


51


No. Winthrop Community Hospital


2 FULL NAME


Elizabeth B. Burns


( Canavan


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(a) Residence.


No ..


(Usual place of abode)


112 Byron St.


St.


East Boston, Mass.


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


months


4


days. In place of residence.


.years.


months


days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


MARCH


2


1957


(Year)


(Month) (Day)


4 I HEREBY CERTIFY,


That I attended deceased from


Jan 3


19


5€


to


March 2


1957


I just saw hizalive on


3/2


1957, death is said to


have occurred on the date stated above, at


6.550 m.


INTERVAL BETWEEN ONSET AND


DEATH 3 DAYS


3-yus


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed?


10


What test confirmed diagnosis?


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


(Signed).


Fred o' Began


M. D.


(Address)


113 Pleasant It Buther


Date


3/2


1957


6 Holy Cross


Malden. Mass.


Piace of Burial or Cremation


(City or Town)


DATE OF BURIAL March 6, 57


19


7 NAME OF


FUNERAL DIRECTOR


Arthur J. O'Maley


Winthrop Mass.


ADDRESS


Received and fied


1357 19


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


White


9 COLOR


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Widowed


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


George M. Burns


(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 :


Housewife


(Kind of work done during most of working life)


14 Industry


or Business:


Own Home


15 Social Security No.


None


16 BIRTHPLACE (City)


(State or country)


Mass.


17 NAME OF


FATHER


Patrick Canavan


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER Emma Dubberley


20 BIRTHPLACE OF MOTHER (City) (State or country) Nova Scotia


21 Informant John A. Canavan


(Address)


212 Cottage Park Rd. Winthro


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : valku ( tettaus 3/5 /54 (Signature of Agent of' Board of Health or other) Hearthe Fraiche (Official Designation) (Date of Issue of Fermiit) 7


X


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


CORONARY THROMBOSIS


(b)


Due To ARTERIO-SCLEROTIL


-


HEART DISEASE


East Boston.


PARENTS


SOM-5-96. 917575


Registered No.


[(If death occurred in a hospital or institution,


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


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


(If nonresident, give city or town and State)


4


CERTIFICATE OF DEATH


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 he 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.


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 bv 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


MAR -61957 AM


INTHEGY


()


1


RECEIVED


X 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


Registered No.


52


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


No.


Maria Sabina Donati (Salotti) 2 FULL NAME


(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 ... 29 Leyden St East Boston St


(Usual place of abode)


Length of stay: In place of death ........... years. months 14 .. days. In place of residence. 29years




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