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