USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 57
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75 | Part 76 | Part 77 | Part 78 | Part 79 | Part 80 | Part 81 | Part 82 | Part 83 | Part 84 | Part 85 | Part 86 | Part 87 | Part 88 | Part 89 | Part 90 | Part 91 | Part 92 | Part 93
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
89 Summit Ave.
St
Winthrop Mass.
(a) Residence. No ..
(Usual place of abode)
Length of stay: In place of death
6years ...... 11
months.
22
days. In place of residence ........... years. months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR
W
10 SINGLE
(write the word)
Married
MARRIED WIDOWED or DIVORCED
10a If married, widowed, or divdleden J Smiddy HUSBAND of (Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
AGE
Yrg'sual
Occupation :
Longshoreman
(Kind of work done during most of working life)
14 Industry
or Business:
Retired
15 Social Security No.
029-05-5302
16 BIRTHPLACE (City)
(State or country)
Lagrange Wisconsin
17 NAME OF FATHER John E Pfeifer
18 BIRTHPLACE OF
Germany
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Caroline Wagner
20 BIRTHPLACE OF
MOTIIER (City)
(State or country)
Wisconsin
Helen J Pfeifer
21 Informant. (Address)
A TRUE COPY
ATTE
Charles 2. Macke
(Registrar of City or Town where death occurred)
DATE FILED
August 16/57
19
(Registrar of City or Town where deceased resided)
10-15
Due To
(b)
Hypertension
Due To
(c)
Obesity
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed ?...
No
What test confirmed diagnosis ?..
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
Nezih Sevunduk Boston State Hospt
M. D.
(Address) ..
Winthrop Cem-Winthrop Mass.
6
Place of Burial or Cremation
August 14/57 19
DATE OF BURIAL.
7 NAME OF FUNERAL DIRECTOR
F J Magrath East BostonMas's.
ADDRESS
Received and filed. SEP 18 1957 19
¿tj or Town)
5031.11.55-916145
at the time of death should be transmitted on Form R.302 to the clerk of the city or town in which the deceased resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. 1 .. )
No.
John E Pfeifer
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(If nonresident, give city or town and State)
3 DATE OF
DEATH
August 12/57
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
July, 119
57
August
12
That I attended deceased from
57
19
I last saw heralive on
August 12 19 57
death is said to
have occurred on the date stated above, at
6;45AM
m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Myocardial infarction
INTERVAL BETWEEN ONSET AND DEATH
2-3 Days
49
ears ..
Months.
Days
If under 24 hours
Hours ........ Minutes
PARENTS
Date
Aughat 12/57
X
302
1
Boston State Hospt. Bosta
RECEIVE.
TOWA
F
0
71.12. 4
10.
ERK
6
SEP 1 81957 AM
302
1
PLACE OF DEATH
Suffolk
(County)
Bos ton
(City or Town)
LIDER
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)
7528
Registered No.
$ (If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
(Was deceased a
U. S. War Veteran,
Winthrop Maggf! WAR)
S
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years.
.. months.
15
.days. In place of residence.
.. years.
months
.days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Charles Schmidt
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
2 Weeks
AGE.
56Years
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.
Brooklyn New York
16 BIRTHPLACE (City).
(State or country)
17 NAME OF FATHER Charles F Egan
18 BIRTHPLACE OF
FATHER (City)
(State or country)
New York
19 MAIDEN NAME
OF MOTHER
Mary Murphy
20 BIRTHPLACE OF
New York
MOTHER (City).
(State or country)
Charles Schmidt
A TREE COPY Les A. Track
ATTEST: (Registrar of City or Town where death occurred)
DATE FILED
August ... 19/57
19.
Mae F Schmidt
2 FULL NAME.
(a) Residence. No.
27 Enfield Road
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August 14/57
July31
19 ..
57
to ...
August 14
have occurred on the date stated above, at
3 AM
m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Small bowel infarction
Due To
Peritoneal adhesions
(b)
(c)
OTIIER
Cystic left cerebral
SIGNIFICANT
Was autopsy performed ?.... Yes
What test confirmed diagnosis ?
autopsy
(Signed)
C L Clay
(Address).
Magg. General Hospt
6
Place of Burial or Cremation
DATE OF BURIAL.
7 NAME OF
FUNERAL DIRECTOR J O'Maley
Copies of returns ot deaths which occurred in your city or town in case the deceased resided in another city or town
Due To
Multiple abdominal operation
resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, See. 12, G. L.)
CONDITIONS
infarct,old
at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased
(Month) (Day) (Year)
4 I HEREBY CERTIFY,
That I attended deceased from
19 57
I last saw
er .. alive on
August 14, 19 57 death is said to
INTERVAL BETWEEN ONSET ANO DEATH
Yrs
Yrs
2 Yrs
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify
M. D.
19
Winthrop Cem-Winthrop Mass.
(City, or Town)
Angust 17/57 19
ADDRESS Winthrop Mass.
Received and filed.
SEP 19 1957
19
(Registrar of City or Town where deceased resided)
PARENTS
5011.11.55.916145
.
×
Masg. General Hospt.
No.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
40
21 Informant. (Address)
RECEIVE.
TOWN
OF
11 12. 3 CLERK
SEP 1 91357 A:
302
XI 1
PLACE OF DEATH
‘Suffolk
(County)
Boston
(City or Town)
No.
Boston City Hospt.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Bo stm
(City or Town making this return)
766971
$(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
Mary Moynahan or Moynihan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
S
(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
8 SEX
F
9 COLOR
White
10 SINGLE
MARRIED
(write the word)
Married
10a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
John J Moynihan
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
7 Days 12
AGE 39Years.
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 :
At Home
15 Social Security No ...
022-01-8721
16 BIRTHPLACE (City)
(State or country)
Boston ...... Mas.g.
17 NAME OF FATHER
Henry Johnson
18 BIRTHPLACE OF
Providence R.I.
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Gertrude O'Rourke
P.E.I.
MOTIIER (City) (State or country)
21 Informant. (Address)
John J Moynihan
7 Centre St. Winthrop
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred) August 22/57
DATE FILED
19
X
-
5031. 11.55 916145
2 FULL NAME
7 Center St.
(a)
Residence. No.
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
(Day)
have occurred on the date stated above, at
5;20PM
m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Due To
(b)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
No
What test confirmed diagnosis ?.
clinical
(Signed)
M W O'Connell
6
Place of Burial or Cremation
DATE OF BURIAL
F J Magrath
7 NAME OF
FUNERAL DIRECTOR
resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, (. 1 .. )
at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased
(c)
Hodgkin's Disease
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town
Due To
Staphylococcal pneumonia
August 18/57
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
August 11.7/57
to
August 1819 ....... 57
I last saw h ... . @live on
19
death is said to
INTERVAL BETWEEN ONSET AND DEATH
Mediastinal compression due to
lymphadenapthy prob.
7 Yrs
Days
5 Was disease or injury in any way related to occupation of deceased? If so, specify ...
M. D.|.
(Address)
Boston City Hospt
8-19
19
57
Woodlawn Cem-Everett Mass .
Gity or Town)
August 21/57
19
East Boston Mass.
ADDRESS
Received and filed.
19
(Registrar of City or Town where deceased residled)
Registered No.
(Was deceased a
U. S. War Veteran,
if
specify WAR)
Win throp
Mass .
WIDOWED
or DIVORCED
PARENTS
20 BIRTIIPLACE OF
SEP 2 2357 '
302
1
Doston
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
Boston
(City or Town making this return) 172
7711
S(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 widow wed or divorced woman, give also maiden name.)
Home of Little Sisters of the Poor
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ........... years ...
months.
9
days. In place of residence445.
.years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August 19/57
(Month)
(Day)
(Year)
4 [ HEREBY CERTIFY,
August 15 57 to.
That I attended deceased from
August
19, 57
I last saw h ... emlive on
August 1919 57, death is said to
have occurred on the date stated above, at
2:45PM
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Coronary thrombosis
Due To
Arterio sclerotic heart disease
(b)
Yrs
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performedNo What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify .
(Signed) S Yuen
(Address)
Boston State Hospt 8-19 19 57
Tufts School of Med.
General Laws
Place of Burial or Cremation August 21/57 19
DATE OF BURIAL
7 NAME OF
J S Waterman & Sons
FUNERAL DIRECTOR
ADDRESS Boston ... Mas s.
Received and filed. SENT. 24. 1957 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F
9 COLOR
W
10 SINGLE
(write the word)
MARRIED
WIDOWED Single
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
87
AGE.
Years.
Months.
Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Retired
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
Charles Meahan
18 BIRTHPLACE OF
Ireland
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Catherine Green
20 BIRTIIPLACE OF
MOTHER (City)
(State or country)
England
21 Informant (Address)
Bostan State Hospt
A TRUE COPY
Garles it. Macke
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
August ... 26/57
19
VB V
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town
at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased
resided as soon as possible, after the close of the month in which the death occurred. (Sec Chap. 46, Scc. 12, G. L.) .
50MI 11.55.916145
PLACE OF DEATH
Suffolk
(County)
CERTIFICATE OF DEATH
Registered No.
Boston State Hospt
No.
Martina Meahan
(Was deceased a
U. S. War Veteran,
if
ify WAR.
Winthrop Mass.
(a) Residence. No .. (Usual place of abode)
INTERVAL
BETWEEN
ONSET AND
DEATH
1 Day
New Brunswick
PARENTS
M. D.
FORM R-302 1
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
PLACE OF DEATH
(County)
Bost a
(City or Town)
The Commonwealth of Massarinisetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF
Besten
(City or Town making this
771
CERTIFICATE OF DEATH
Registered No.
S(If death occurred in a hospital or in St. { give its NAME instead of street and
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Home of Little Sisters of the Poor, 19 Summ t Av
(a) Residence. No .. (Usual place of abode)
Length of stay: In place of death ............ years ....
.months.
9
days. In place of residence.
.. years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF DEATH
August 19/57
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
August, 15/ 5%
August ...... 1.9,
19.
I last saw h .... e.afive on
August 19/5,7 death is said to
have occurred on the date stated ahove, at
2:45P, Mm.
INTERVAL BETWEEN ONSET AND DEATH
1 Day
Due To
Arterio sclerotic heart
(1))
disease
Due To (c)
OTHER 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
(Signed) S Yuen M. D.
Boston State Hospt 8-19
19
(Address)
Tufts School of Medicine
6
Place of Burial or Cremation August 21/57 19
(City or Town)
DATE OF BURIAL
7 NAME OF UNERAL DIRECTO
J S Waterman & Sons Boston Mass.
ADDRESS
Received and filed. SEP 25 195 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULAR
8 SEX
F
9 COLOR
10 SINGLE
(write
S
W
MARRIED
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Hushand's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 87 Years.
Months .....
Days
If under 24
Hours ........
13 Usual
Occupation :
Retired
(Kind of work done during most of worki
14 Industry
or Business:
15 Social Security No ....
New Brunswick
16 BIRTHPLACE (City)
(State or country)
17 NAME OF FATHER
Charles Meeha
18 BIRTHPLACE OF
Ireland
19 MAIDEN NAME OF MOTHER Catherine Gree
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston State
21 Informant (Address) Boston Mas
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occ
DATE FILED
August 26 /57
MARGIN RESERVED FOR BINDING
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
50M -: 1-55-916145
Suffolk
Boston State Hospt.
No.
Martina Meahan
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Winthro
(If nonresident, give city of town
45
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Coronary thrombosis
Yrs
PARENTS
FATHER (City) ..
(State or country)
England
302
1
Bostan
(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. 1 73 7806
((If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
Ruth Scott
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 ..
(Usual place of abode)
St
(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.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August 24/57
(Month)
(Day)
(Year)
4 | HEREBY CERTIFY,
That I attended
August 24
deceased from
57
Aug.4,
19
57,
to
August, 24/57
said to
have occurred on the date stated above, at
12;18PM
DEATH WAS CAUSED BY: IMMEDIATE CAUSE Malignant lymphoma stemm cell
(a)
type
Due To
with massive involvement
(b)
of lungs and liver
2 Mos
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Yes
Was autopsy performed?
What test confirmed diagnosis?
autopsy
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
M. D.
(Address)
Mass, General Hospt 19
20 BIRTHPLACE OF
Latvia
Jewish Nat. Workers Cem-Danvers
Mas GQTHER (City). (State or country)
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL.
August 26/57 19
....
7 NAME OF
FUNERAL DIRECTOR
B Schlossberg & Sons
Mattapan Mas's.
ADDRESS
Received and filed SEP 2% 1957 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F
9 COLOR
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
10a If married, widowed, or divorced HUSBAND of.
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
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:
At Home
15 Social Security No ..
None
16 BIRTHPLACE (City)
(State or country)
17 NAME OF FATHER Joseph Latt
18 BIRTIIPLACE OF
FATHER (City)
(State or country)
Latvia
19 MAIDEN NAME OF MOTHER
Ida Herzkovitz
(Signed)
D A Clark
PARENTS
21 Informant. (Address)
Israel Scott 40 Trident Ave Winthrop
A TRUE
ATTEST:
Orles H. macks.
(Registrar of City or Town where death occurred)
DATE FILED
August 28/57
19
Copies of returns ot deaths which occurred in your city or town in case the deceased resided in another city of town
at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased
resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) .
SOM1.11.55.916145
5
PLACE OF DEATH
Suffolk (County)
Mass. General Hospt.
No.
40 Trident Ave.
Winthrop Mass.
19
I last saw h ....... @Ive on
(Give maiden name of wife in full)
Igrael Scott
INTERVAL BETWEEN ONSET AND DEATH 4 Mos 12 AGE 66
Housewife
Latvia
RECEIVE )
TOW
IF
;LERK
0
SEP 871957 EM
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.
S(If death occurred in a hospital or institution,,
St. { give its NAME instead of street and numher)
2 FULL NAME.
Annie F. (Moore) Enright
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Eliot
St
Winthrop.
(If nonresident, give eity or town and State)
Length of stay: In place of death ............ years ....
....... months.
10
.days. In place of residence ............ years ....
.. months.
.days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
Married
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
James A. Enright
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
85
AGE.
Years
Months.
.Days®
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Salesl dy
(RETIREd) J. J.S.
(Kind of work done during most of working life)
14 Industry
Clothing store
or Business :
15 Social Security No ..
023-01-2479
16 BIRTHPLACE (City)
(State or country)
Ireland
17 NAME OF
FATHER
James Moore
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Mary
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21
Informant
(Address)
20 Eliot st. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the bugfal or transit permit was issued: Kalch Serianme
A: O.
(Signature of Agent of Board of Health or other) arte Sept. 6/37
(Official Designation )
(Date of Issue of Permit)
100M. 11.55-916145
7 NAME OF
FUNERAL DIRECTORJohn J. Spencer
ADDRESS
527 Broadway,So. Boston
Received and filed
SEP C - 1957
19
(Registrar)
INTERVAL BETWEEN ONSET AND DEATH 2 DAYS
Due
ABTEIG-SCLARCTIC
(h)
HEART DISEASE
5 yes
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed ?.
What test confirmed diagnosis ?.
5 Was disease or injury in any way related to occupation of deceasedle If so, specify.
(Signed
Fred D Regan
113 Places ong de Withich
Date 4/5
157
Holy Cross
Malden
6 Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
Sept. 6
19.57
M. D.
(Addre
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
19:57
June 1
1957
to ......
{ last saw
hetalive on
Left 4'
. 1957
ICH
have occurred on the date stated ahove, at .. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
BRONCHO-PNEUMONIA
(a)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
4
1457
No.
Mount's Conv. Home 104 Highland ave
To be filed for burial permit with Board of Health or its Agent.
301A 1
ONS
TIFICATE
ng DEATH nter one each nd (c)
not mean dying, failure, It means · compli- caused
if any, rise to (a), under- last.
contrib. but not terminal on given
pter 137, requires print or ause or eath on
ates.
James A. Enricht
124
(a) Residence. No ..
(Usual place of abode)
No
PHYSICIAN - IMPORTANT
(Was deceased a
. U. S. War Veteran,
if so specify WAR)
Mass
(write the word)
·
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- te"n, 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 whichit was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.