USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 83
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
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
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
To be filed for burial permit with Board of Health or its Agent.
No. 79 Johnson Ave.
[(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
2 FULL NAME
Lila Chicken
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 79 Johnson Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
5
.years.
_. months
days. In place of residence 5.
years.
.months _...
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OFNT
DEATH November
30
1957
(Month)
(Day)
(Year)
8 SEX
Female
White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWEDWidowed
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
Jan. 18,
1956
to
Nov. 30,
19
5.7
I last saw b.Oralive on
NOV.
29 , ..... , 19.5.7., death is said to
have occurred on the date stated above, at
11:25p. m.
INTERVAL
BETWEEN
ONSET AND
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
arteriosclerotic and hypertensiv
(a)
heart disease
23 yrs
Due To
'generalized arterioslerosis
4 yrs.
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
benign nephrosclerosis
2 yrs.
Was autopsy performed?
no
What test confirmed diagnosis? Clinical & Laboratory
5 Was discase or injury in any way related to occupation of deceased ? If so, specify
(Signed)
M . Traunstein
M. D.
(Address). 73 Bartlett Rd.
Date.
12/2/
19.57
Mass.
6
Woodlawn Cemetery Place of Baritt of Cremation DATE OF BURIAL December 3 1957
7 NAME OF
FUNERAL DIRECTOR_
Celfred BB. March
ADDRESS 174 Winthrop St .- Lathrop
Received and filed
DEC
19
(Registrar)
PARENTS
18 BIRTHPLACE OF
Rochester,
FATHER (City)
(State or country)
N. H.
19 MAIDEN NAME
OF MOTHER
Mooney
20 BIRTHPLACE OF MOTHIER (City) (State or country) N. H.
21
Informant
Mrs. Garfield J. Hewson
(Address)
79 Johnson Ave, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with mc BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of llcalth or other)
(. Healla
123,57
(Official Designation)
(Date of Issue of Permis)
$
CATE
CATH r ne ch (c) mean dying, failure, means ompli- caused
any, to (a), der- last.
ntrib -- > ut not rminal given
₹ 137, quires int or e or h on ..
SOM-3-36-917573
1
240
Registered No.
PHYSICIAN - IMPORTANT
¿ ¿ Was deceased a
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
PERSONAL AND STATISTICAL PARTICULARS
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE
Charles Fred Chicken
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 84 Years.8
Months
6
Days
If under 24 hours
... Hours .... Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business :
own home
15 Social Security No.
110
Rochester
16 BIRTHPLACE (City)
(State or country)
N. H.
17 NAME OF
FATHER
Roscoe Flanders
housewife
(b)
Winthrop
Everett. Mass
(City or Town)
-
1A
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 seventecn. 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 be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical. thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury .a human body or the ashes thereof which have been brought into the commonwealth until, he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the intermen't 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 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
X
PLACE OF DEATH
Suffolk (County)
I
inthron
(City or Town), 511 32 best Rus Murphy
No.
2 FULL NAME
Marietta
Hills
(If deceased is a married, widowed or divorced woman, give also maiden name.)
125 Cliff Ave.
(a) Residence.
No.
(Usual place of abode)
2
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
Nov
30
1957
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, That I attended deceased from
may
to.
IVO 30
1953
5%
I last saw h2xalive on
CTck, 30
19
death is said to
57
have occurred on the date stated above, at
12:101A
.m.
INTERVAL
BETWEEN
ONSET AND
DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
Years.
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Forselife
(Kind of work done during most of working life)
14 Industry
or Business:
At Foe
15 Social Security No ...... 0:20
16 BIRTHPLACE (City).
Stoughton
(State or country) : 2s.c .
17 NAME OF A Thent Cross an FATHER
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ver ont
19 MAIDEN NAME
OF MOTHER
Sarah Stearns
20 BIRT11PLACE OF
MOTHER (City)
(State or country)
esstchusetts
21 recorde C ...
Informant
(Address)
own of Jackman
1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the Hurial or transit permit was issued:
(Signature of Agent of Board of Health or other)
1 × 3. ??
(Official Designation)
(Date of Issue of l'ermit)
e
(c) mean dying, ilure, means ompli- aused
zny, to (a), der- last.
trib. t not minal given
: 137, uires nt or or on ב
(Signed)
peple fregone
M. D.
(Ad Es 19 4 latachrusia ax Date 12-2 1937
6 Iinthron Place of Burial or Cremation
(City or Town)
Dec.
1957
DATE OF BURIAL
Kawards Chymotors
ADDRESS
7 NAME OF
FUNERAL DIRECTOR
Winthrop Thans.
Received and filed
DEC :2 1957
19
(Registrar)
PARENTS
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
Thite
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Viaow
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Harry
H Hills
(Husband's name in full)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
cicate left Ventricular
(a)
dilatation
Due To
arterusclerosis - generalized
(b)
(c)
myocardial Heart
vescasa
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
ivo
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
advies, bagnthron
SOM-3-56-917573
LA
CATE
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
[(If death occurred in a hospital or institution,
St. [give its NAME instead of street and number)
PHYSICIAN - IMPORTANT -
(Was deceased a
U. S. War Veteran,
if so specify WAR)
St.
(If nonresident, give city or town and State)
26
reina Home
ATH ·
min
7.3
10
22
-
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 ninetcen 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 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, Scc. 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 willinvestigate and certify to all deaths supposably due to injury. Theseinclude 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
×
PLACE OF DEATH
Suffolk (County)
Quindi 12-8-57
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
242
St. (give its NAME instead of street and number) No. Winthrop Community Hospital
2 FULL NAME Sullivan, Francis
(If deceased is a married, widowed or divorced woman, give also maiden name.)
24 Billings St.
St.
Quincy
Mass
(If nonresident, give city or town and State)
Length of stay: In place of death
years
months
days. In place of residence.
20 years.
.months _....
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
November
30
1957
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, That I attended deceased from
Nov ..... 29
19.
57 to Nov. 30
19.57
I last saw h. LMlive on
Nov. 30
19.57, death is said to
have occurred on the date stated above, at
10:45p.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Pneumonia bilateral
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Cardiac decomposition
Was autopsy performed?
What test confirmed diagnosis?
X-Ray
5 Was disease or injury in any way related to occupation of deceased Ne
If so, specify ...
(Signed)
(ed) Josephe Gregone
M. D.
(Address)
199 Washington Une
Date // - 30
6 110 Place of Hurjar of Cremation 4 DATE OF BURIAL 95%
7 NAME OF
FUNERAL DIRECTOR
C.V. Derhave
ADDRESS
333 Howeach It Quency
Received and filed
DEC 2 1957
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Single
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
2 daysAGE3d
Years
Months
.Pays
If under 24 hours
Hours ......
Minutes
13 Usual
machinist
(Kind of work done during most of working life)
14 Industry
or Business:
machine Shop.
15 Social Security No.
Boston
16 BIRTHPLACE (City)
(State or country)
maso
PARENTS
17 NAME OF
FATHER
Dennis Sullivan
18 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
mais
19 MAIDEN NAME
OF MOTHER
Catherine Bates
20 BIRTIIPLACE OF
Boston
MOTHER (City) ....
(State or country)
maas
21 John Sullivan
Informant
(Address)
24 Beelings St. No Juicy
I IIEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
(Signature of Agent of Board of Health or other)
(Oficial Designation)
(Date of Issue of Permit)
12 3/1,
X
INS
FICATE
3
EATH ter one ach d (c)
t mean dying, failure, t means compli- caused
any, ise to (a), under- last.
ontrib -- but not terminal n given
ter 137, equires print or use or ath on tes.
SOM-5-56-917573
-
Winthrop (City or Town)
Registered No.
[(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
no
(a) Residence.
No.
(Usual place of abode)
(write the word)
Occupation :
INTERVAL BETWEEN ONSET AND DEATH
Diabetes Mellitus
Boston
(City or Town)
01A 1
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.
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.