Town of Winthrop : Record of Deaths 1957, Part 30

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 30


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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No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the tommonwealth until he has received a permit so to do from the board of health orits agent appointed to issue such permits, or if there is no such board; front the clerk of the town where the body is to be buried or the funeral is to be held, or fromla person appointed to have the care of the cemetery or burial ground in which the interment is made.


. . Chap. 114, Sect 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 willcertify 16 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 physicianswill 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 deallis 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 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


......


S ( r S r a T C 5 a r T 1 e C


C 1 - t - 1 1 1


X


PLACE OF DEATH


(County)


(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 this return)


Registered No.


2334


87


y


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


2 FULL NAME Fugene J NcCarthy


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


215 Pleasant


Winthrop, Mass


St


(If nonresident, give city or town and State)


months.


......


... days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


M


9 COLOR


10 SINGLE


(write the word)


MARRIED WIDOWED or DIVORCEDHarried


4 I HEREBY CERTIFY,


That I attended deceased from


Mer 7 19. 52


to .. Mar 18


19.


57


Mar 13, 19 57, death is said to


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


have occurred on the date stated above, at


9:51A


.. m.


INTERVAL BETWEEN ONSET AND DEATH


11 IF STILLBORN, enter that fact here.


12


AGE.60 Years.


Months.


Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


Attorney


(Kind of work done during most of working life)


14 Industry


or Business:


N.E. Power Co


15 Social Security No ...


16 BIRTHPLACE (City)


(State or country)


Last Poston


Mass


17 NAME OF FATHER


Frank D Mccarthy


18 BIRTHPLACE OF


FATHER (City)


Poston


(State or country)


Mass


19 MAIDEN NAME OF MOTHER Mary P Donovan


20 BIRTHPLACE OF


MOTHER (City)


Eoston


(State or country)


Mass


21 Informant. (Address)


A TRUE COPY


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED Mar 26 1 57


1.8


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


50ML 11.55 916145


(Signed) J I Robert M. D.


(Address)


LL1 Stuart St


Date. 3-18 19 57


6 Winthrop Cem Place of Burial or Cremation


Winthrop


(City or Town)


DATE OF BURIAL


Mar 21 1957


7 NAME OF FUNERAL DIRECTOR A J CIMaloy


ADDRESS


inthrop Mass


Received and filed JAY 13 ,1957 19


(Registrar of City or Town where deceased resided)


10a If married, widowed, or divorced


HUSBAND of


Katherine Moran


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE (a)


Coronary thrombosis


Malignant Hypertension


3 yrs


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed? NO


What test confirmed diagnosis? Physical Exam


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


PARENTS


Wifc.


(Was deceased a


U. S. War Veteran,


if so specify WAR)


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


Length of stay: In place of death ............ years. months. .days. In place of residence. 50 years


3 DATE OF


DEATH


March


18


1957


(Month)


(Day)


(Year)


No


4141 Stuart


7


R-302 1


RECE'VEM


B


5


MAY 1 31957 AT


M R-305 1


PLACE OF DEATH


(County) BROOKLINE


(City or Town)


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


BROOKLINE


(City or town making return)


Registered No.


245


88


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


2 FULL NAME ..


John A .Hunter


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


(Was deceased a


U. S. War Veteran,


if so specify WAR).


no


(a) Residence. No.


121 Tafts Avenue


(Usual place of abode)


St.


Winthrop ...


Massachusetts


(If nonresident, give city or town and State)


Length of stay: In place of death.


........... years.


months


1 3/4 hrs


days


In place of residence.


2.years


.. months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


9 SEX


male


10 COLOR OR RACE


white


11 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED widowed


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.)


Arterio-sclerotic hypertensive heart


disease with acute Coronary Occlusion


(sudden death)


5 Accident, suicide, or homicide (specify)


no


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?


(Specify type of place)


Manner of


Injury


(How did injury occur?)


Nature of


Injury


While at work?


no


.Was autopsy performed?


no


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


If so, specify


Thomas P Kendrick


(Signed)


ust Washington St


M. D.


(Address)


Brookline, Mass


Date A.D.C IJ 1957


DATE OP BURIAL April 15 1957


& NAME OP


PUNERAL DIRECTOR


John C Kelly


ADDRESS


286 Meridian St. East Boston, MasATTEST:


Received and filed.


MAY 13 1957


19


...


11a If married, widowed, or divorced


HUSBAND of.


Mary A. Doherty


(Give maiden name of wife in full)


(or) WIPE of.


(Husband's name in full)


12 IF STILLBORN, enter that fact here.


13


AGE.62 .... Years.


Months.


.Days


If under 24 hours


Hours


Minutes


14 Usual


Occupation :


Superintendent


15 Industry


Dry Goods


or Business:


16 Social Security No ..


.025-09-1212


WestQuincy


17 BIRTHPLACE (City)


(State or country)


Massachusetts


18 NAME OP


PATHER


Hugh Hunter


19 BIRTHPLACE OF


FATHER (City)


(State or country)


Scot land


20 MAIDEN NAME


OF MOTHER


Elizageth Harvey


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Scotland


Roger J Hunter


7


.Holy Cross ... Cemetery. .... Malden, Massachusetts


Place of burial, or Cremation.


(City or Town)


22


Informant


(Address)


121 Tafts Avenue


Winthrop, Mass.


A TRUE COPY.


(Registrar of City of Town where death occurred)


DATE PILED


April 17


1957


....


(Registrar of City or Town where deceased resided)


PARENTS


25M-5-52-907046


1


NORFOLK


No. 9.SewallAvenue


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-305 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.)


3 DATE OF


DEATH


April


11


1957


(Month)


(Day)


(Year)


no


(Kind of work done during most of working life)


غذاء


MAY 1 31957 ."


R-302 1


Boston


(City or Town)


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


Bostan


(City or Town making this return)


Registered No. 3622


$ (If death occurred in a hospital or institution,


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


2 FULL NAME


John H A Moran


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


42 Harbor View Ave.


S


Winthrop Mass.


(If nonresident, give city or town and State)


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


months.


13.days. In place of residence.


3.7 .years.


... nonths


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


M


9 COLOR


W


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married


10a If married, widowed, or d HUSBAND of


Mary Louise Walsh


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


75


Years


8


20


Months.


Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


Ass 'st Supt. of Mail


(Kind of work done during most of working life)


14 Industry


or Business :


U S Post Office


15 Social Security No.


Non e


16 BIRTHPLACE (City)


(State or country)


17 NAME OF FATHER Hugh F Moran


18 BIRTHPLACE OF


FATHER (City)


(Statc or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Margaret Connelly


(Signed)


C L Clay


M. D.


(Address)


Masg. General Hospt


4-13


57


19


St Joseph's Cem-West Roxbury


Place of Burial or Creination" (City or Town)


DATE OF BURIAL


April 16/57 19


7 NAME OF


FUNERAL DIRECTOR


R C Kirby


ADDRESS East Boston Mass.


Received and fled


MAY 2417


19


(Registrar of City or Town where deceased resided)


0


vr. .


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


5031.11.55.916145


5.


PLACE OF DEATH


Suffo lk


(County)


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


April 13/57 . (Day) (Year)


4 I HEREBY CERTIFY,


That I attended deceased from


April 7 19 57


to ...


April .13


19.


5.7


I last saw himalive on


April 13


1957


death is said to


have occurred on the date stated above, at 9;55A m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) Uremia


INTERVAL BETWEEN ONSET AND DEATH 4 Days


5 Yrs


Due To


Hypertensive arterio


sclerotic heart disease with


congestive heart failure


3 Wks


17 Yrs


OTHER


Diabetes mellitus


SIGNIFICANT CONDITIONS


Was autopsy performed? What test confirmed diagnosis?


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


PARENTS


Mass.


MOTHER (City). (State or country )


Wife


TRUE COPY


El Luackie


ATTEST:


(Registrar of City or Town where death occurred )


DATE FILED April 17/57 19 .. ....


(Was deceased a


U. S. War Veteran,


if so specify WAR)


89


3 DATE OF


DEATH


(Month)


Mass. General Hospt.


No. .


21 Informant (Address)


20 BIRTHPLACE OF


Ireland


East Boston Mass.


RECEIVED


TOW


OF


OFFICE


1


-


GLERK


6


THROP


MAY 2 41957 AM


R-302 1


PLACE OF DEATH


Suffolk


(County)


Boston


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


Boston


(City or Town making this return)


367350


Registered No.


-


Peter ent Brigham Hospt. No.


$(If death occurred in a hospital or institution,


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


Patrick Mulraney


2 FULL NAME


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


19 Fremont


St


Winthrop Mass


(If nonresident, give city or town and State)


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


months


33


lays. In place of residence 47 years.


.. months.


.. days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


April 15/57


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


March, 13 57


to


April 15


57


That I attended deceased from


I last saw himalive on


April 15


, 19 57


death is said to


have occurred on the date stated above, at


3 AM


m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) Carcinoma of stomach


INTERVAL BETWEEN ONSET AND DEATH 2 Mos


11 IF STILLBORN, enter that fact here.


12


AGE.7.1 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:


Public School


15 Social Security No ..


024-24-9849


16 BIRTHPLACE (City)


Ireland


(State or country)


17 NAME OF


FATHER


Edward Mulraney


18 BIRTHPLACE OF


FATHER (City)


(Statc or country)


Ireland


(Signed)


V M Cass


M. D.


Peter Bent Brigham Hospt 4-15-50 BIRTHPLACE OF Ireland


(Address) Winthrop Cem-Winthrop Mass.


6


Place of Burial or Cremation (City or Town)


DATE OF BURIAL


April 17/57


19


7 NAME OF


FUNERAL DIRECTOR


A J O "Maley


ADDRESS Winthrop Mas s.


Received and filed MAY 2 # 1951 19


-


(Registrar of City or Town where deceased resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


M


9 COLOR


W


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Married


19 HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


Term.


(b))


Due To


Myocardial infarction


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


No


What test confirmed diagnosis?


Clinical


No


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


YARENTS


19 MAIDEN NAME


OF MOTHER


Bridget McDade


MOTHER (City)


(State or country)


21 Informant. (Address)


Delia Mulraney


A TRUE COPY LA Mackie


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


April 18/57


19


V.I. V


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town 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


50M .11.55.916145


(City or Town)


U


CERTIFICATE OF DEATH


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(a) Residence. No.


(Usual place of abode)


widowed, or div


Delia Ferrins


Retired Custodian


RECEIVED


OF


TOWA


OFFICE


11 12


ID.


CLERK


V


6


5


1


MAY 2 41957 AM


M R-305 1


PLACE OF DEATH


1 SUFFOLK BOSTON


(City or Town)


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


BOSTON


(City or town making return)


3859


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.)


4] Ocean Ave.


Winthrop Mass.


St.


(a) Residence.


No.


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death ..


.. years ..


1 months 14


1.8years


.days. In place of residence.


.months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


April 23/57


(Month)


(Day)


(Year)


9 SEX


F


10 COLOR OR RACE


11 SINGLE


MARRIED


WIDOWEWido wed


or DIVORCED


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.) Broncho pneumonia fracture of femur


11a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


Henry H Block


(or) WIFE of.


(Husband's name in full)


12 IF STILLBORN, enter that fact here.


13


AGE


Years


80


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:


At Home


16 Social Security No.


17 BIRTHPLACE (City)


(State or country)


Russ ia


18 NAME OF


FATHER


Max Astrin


19 BIRTHPLACE OF


FATHER (City).


(State or country)


Russia


20 MAIDEN NAME


OF MOTHER


Libby -----


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Russia


Tifereth Israel of Winthrop-


7 Place of Burial, or Cremation. (City of Town)


DATE OF BURIAL


April 24/57


19


8 NAME OF


FUNERAL DIRECTOR


Murray


Goldman


Malden Mas's.


ADDRESS


Received and filed


MAY 2.9 1957


19


(Registrar of City or Town where deceased resided)


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


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


Manner of


Injury


Accidental fall


(How did injury occur?)


Nature of


Injury


Fracture of femur


While at work?


Was autopsy performed?


.No


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


If so, specify.


(Signed)


Michael A Luongo


(Address) 25 Shattuck St, Date 4-23 19


M. D.


51


22


Informant


(Address)


Julian L Block


A TRUE COPY,


ATTEST: .... 0


Charles & Iackie


(Registrar of City or Town where death occurred)


DATE FILED


April 24/57


19


......


5 Accident, suicide, or homicide (specify) ..........


accident


Date and hour of injury.


March 21


57


Where did


Injury occur?


Winthrop Mass.


(City or town and State)


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


(Specify type of place)


PARENTS


1.5.


Mass. General Hospt. No.


Ida M Block


(Was deceased a


U. S. War Veteran,


if so specify WAR)


91


(write the word)


RECEIVED


0.


6


MAY 2 91957 Mi


X


PLACE OF DEATH


Suffolk


(County)


Bos ton


(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 this return)


4018


Registered No.


(Was deceased a


U. S. War Veteran,


if so specify WAR)


92


Winthrop Mass.


St


(If nonresident, give city or town and State)


Length of stay: In place of death ..


.......... years.


.months.


......


.. days. In place of residence.


25


.. years.


.months.


......


days.


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


F


9 COLOR


W


10 SINGLE


(write the word)


MARRIED


WIDOWED


Widowed


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Frank Gorodetsky


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE


82 Years.


Months ..........


.Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


House wife


(Kind of work done during most of working life)


14 Industry


or Business :


At Home


15 Social Security No.


None


16 BIRTHPLACE (City) Ruggi.a (State or country)


17 NAME OF FATHER Mones Schneiderman


PARENTS


18 BIRTHPLACE OF


Russia


FATHER (City) (State or country)


19 MAIDEN NAME


OF MOTHER


Sossel


--


20 BIRTHPLACE OF


Russia


MOTHER (City)


(Statc or country)


21 Informant. (Address)


A TRUE COPY carles & Machen


ATTEST:


(Registrar of City or Town where death occurred)


April 29/57


DATE FILED


19


100 Locust St.


(a) Residence.


No ...


(Usual place of abode)


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


(Month)


4 I HEREBY CERTIFY,


March.,1 19 ....


57


to ..


I fast saw h .. eralive on


April 24, 19 57


have occurred on the date stated above, at


9 PM


.m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


Pulmonary .... edema


heart failure


(c)


OTHER


SIGNIFICANT


CONDITIONS


(Signed


Dr Tan os Tarai


Jewish Mem.Hospt


(Address)


6


Place of Burial or Cremation


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


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town


Due To


Universal arterio sclerosis


April 24/57 (Day) (Year)


That I attended deceased from


April 24


57


19


death is said to


INTERVAL BETWEEN ONSET ANO DEATH 2 Days


Due To


Broncho meumonia congestion


(1))


5 Days


Was autopsy performed?


Nme


What test confirmed diagnosis?


Physical examination


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


M. D.


Date.


4-25


19.


57


Anshe Lebovitz Woburn Mass .


DATE OF BURIAL April 28/57 19


7 NAME OF


FUNERAL DIRECTOR Schlossberg & Sons


ADDRESS Mattapan Masg.


Received and filed.


JUN 3 1957


19


(Registrar of City or Town where deceased resided)


I


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


2 FULL NAME Goldie Gor odetsky


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


No


Jewish Memorial Hospt.


R-302 1


50M.11.55-916145


(City or Town)


Harry Gore


·


JUN~31087 KM


X


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 this return)


403393


§(If death occurred in a hospital or institution,


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


2 FULL NAME


George Leet


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


Cambridge St.


St


(If nonresident, give city or town and State)


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


months ..


0


10


.... days. In place of residence. .years.


months.


.. days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


(Month)


April 24/57


(Day)


(Year)


4 I HEREBY CERTIFY,


April 15/ 57


to


April 24


57


19.


That I attended deceased from


I last saw h.1.Malive on


April 24 19


57


death is said to


have occurred on the date stated above, at


10 PM


m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


Broncho peumia


INTERVAL BETWEEN ONSET AND DEATH 1 Week


Due To Carcinoma of larynx with metastases 3 Yrs


OTHER SIGNIFICANT CONDITIONS


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)


I .Robinson


M. D.


(Address)


Mass Eye & Ear Infe


4-2.519 ........ 57


Winthrop Cem-Winthrop Mass.


6 Place of Burial or Cremation (City or Town)


DATE OF BURIAL April 27/57 19


7 NAME OF


FUNERAL DIRECTOR


A P Graham


ADDRESS. Woburn Magg


Received and filed.


JUN-3 1957


19


(Registrar of City or Town where deceased resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


M


9 COLOR


W


10 SINGLE


MARRIED


WIDOWED


Married


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


Josephine Doggett


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE65


.Years


7


.Months.


11


.Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


Retired


(Kind of work done during most of working life)


14 Industry


or Business:


Disabled Veteran


15 Social Security No ..


022-12-0714


16 BIRTHPLACE (City)


(State or country)


East Boston Mass


17 NAME OF FATHER George Leet


PARENTS


18 BIRTHPLACE OF


P.E.I.


FATHER (City)


(State or country)


19 MAIDEN NAME


OF MOTHER


Maud Cook


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Waltham Mass.


21 Informant


Joseph ine Leet


A TRUE COPY


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


April 29/57


19


X


-


.302 1


(h) 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 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)


50M . 11.55.915145


No. ....


Mass. Eye & Ear Infirmary


Registered No.


W W #1


(a) Residence. No.


(Usual place of abode)


Burlington Mass.


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(write the word)


JUN -- 28 57


X


PLACE OF DEATH


Middlesex (County)


Medford


(City or Town)


ATATE


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


Medford


(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


Emma M. Baker




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