USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 76
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
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 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 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 deathsonly 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 (díugs ur 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 SUFFolk (County)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
011
To be filed for burial perml with Board of Health or Its Agent.
07564
Registered No. [(If death occurred in a hospital or institution HOSPITAL St. give its NAME instead of street and number
BABY GIRL VidEAU 2 FULL NAME.
PHYSICIAN - IMPORTANT -
(Was deceased a
U. S. War Veteran,
if so specify WAR).
St.
Winthrop
MASS
(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
7
1958
(Year)
(Month)
(Day)
4 I HEREBY CERTIFY
That I attended deceased from
August 7, 1918, to
August 7
194-8
I last 'saw h ____ alive on
19
, death is said to
have occurred on the date stated above, at
11:40 m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Erythroblastosis Fetalis
INTERVAL BETWEEN ONSET AND DEATN
11 IF STILLBORN, enter that fact here.
12
AGE
Years
Months.
Days
If under 24 hours
Hours /fMinutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business :
15 Social Security No ....
16 BIRTIIPLACE (City)
(State or country)
Boston,
Mass
17 NAME OF
FATIIER
Pierre Videau
18 BIRTIIPLACE OF
FATHER (City)
Paris,
(State or country)
France
19 MAIDEN NAME
OF MOTHER
Paulette San Souci
20 BIRTHPLACE OF
MOTIIER (City)
(State or country)
Woonsocket
Rhode Island
Boston Lying in Hospital
21
Informant
(Address)
221 Longwood Ave, Boston
I HIERERY CERTIFY that a satisfactory standard certificate of de was filed with me BEFORE the, burial or transit permit was issued Kank
(Algnature of Agent of lloard of Health or other)
81131
-JY
(Official Designation)
(Date of Issue of Permit)
STRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH
not enter re than one se for each ), (b) and (c)
s does not mean ode of dying. s heart failure, 1, etc. It means ease. or compli- which 770.5
itions, 1) any, tave rise to lanse the
(b)
(c)
Due To
Prematurity 31 wks.
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed? What test confirmed diagnosis ?.
3 Was disease or injury in any way related to occupation of deceased ? If so, specify.
(Signed). D. (Address) 221 Longwood Ave Date August 8- 1958
6
Winthrop ComeTury.
Winter
Place of Burial or Demation
(City or Town)
DATE OF BURIAL 8,
19
7 NAME OF
FUNERAL DIRECTOR.
Ernest C. C.s.s.
ADDRES 147 Winthrop St. Wenthey
Received and fled AUG 1-1-1958 19 · Charles H. Hacker
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
FEMALE
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
(write the word)
or DIVORCED
Singla
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
PARENTS
SOM-5-57-920345
26 1958
PLACE OF DEATH
RM R-301A - Boston (City or Town)
CERTIFICATE OF DEATH
To Boston Lying-IN
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
(Usual place of abode)/
409 Shirley
Due To
RH Sensitivity
(.), ander- last.
ditions contrib- - o death bat mot to the terminal condition given
Chapter 137, ( 1954, requires ians to print or the cause of of death en certificates.
A TRUE COPY ATTESTI Charles it Mackie City Registrar
NOV 251 59 2:
Suffolk
(County)
Boston
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
212
To be filed for burlal permit with Board of Health or its Agent.
07736
Peter Bent Brigham Hospital No.
f(If death occurred in a hospital or institution,
St. [give its NAME instead of street and numher)
2 FULL NAME Mr John Henry
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
108 Winthrop
St.
Winthrop,
Mass.
(If nonresident, give city or town and State)
Length of stay: In place of death ...
years
months
6
days. In place of residence 31 years.
months .. .... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August
12
1958
(Month)
(Day)
(Year)
WH HEREBY CERTIFY.
ThanPattended deceased from
Aug.
6
19
58
to
Aug.
12
19
58
We last saw himalive on
August ...... 12 , 19.58 , death is said to
have occurred on the date stated above, at
3:00 A .m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Bronchopneumonia
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
Carcinoma Right Lung
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 .
(Signed)
Victora Camas.
M. D.
NO PARENTS
(Address)
P. Bent Brigham Hosp Date Aug. 12 1, 58
Woodlawn (Cremation) 6
Everett Mass.
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL August 15, 1958
19
7 NAME OF
FUNERAL DIRECTOR
Alfred B. Marsh
ADDRESS
174 Winthrop St. Winthrop.
Received and filed
19
AUG 1.5 1958
Charles H. Mackie
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
IO SINGLE
(write the word)
MARRIED
WIDOWED Married
or DIVORCED
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(llushand's name in full)
11 IF STILLBORN, enter that fact here.
12
75
AGE
Years.
10
Month&7
Days
If under 24 hours
Hours . . Minutes
13 Usual
Occupation :
Moving and Storage
(Kind of work done during most of working life)
14 Industry
or Business :
Moving and Storage
15 Social Security No.
013 287 347
16 BIRTHPLACE (City)
(State or country)
"St. John, New Brunswi
il.
Canada
17 NAME OF
FATHER
on
Henry
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Unknown
19 MAIDEN NAME
OF MOTHER
Unknown
20 BIRTHPLACE OF
MOTHER (City)
(State or country )
Unknown
21 Informan
Florence Henry (wife)
(Address) 108 Winthrop St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the hurial or transit pormit was issued : Paula
(Signature of Agent of Board of Health or other) 8984
(Official Designation) (Date of Issue of Permit)
X
R-301A -
UCTIONS FOR CERTIFICATE giving OF DEATH ot enter than one for each (b) and (c)
oes mot mean of dying, heart failure. tc. It means 1. or compli- chich caused
62.7 -
Rs, if an), ave rise to Cause the cause
(s). under- last.
ions contrib .- death but not . the terminal adition given
Chapter 137, 1954, requires os to print or e cause or of death on rtIficates.
SOM-5-57-920345
2 1858
PLACE OF DEATH
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
NO
(Usual place of abode)
INTERVAL
BETWEEN
ONSET AND
DEATH
3 Wks
10a If married,
Florence
irlowed, or divorcedrge Tewksbury
A TRUE COPY ATTEST: Charles it Mackie City Registrar
NOV 2 51 23 AM
R-301A 1
UCTIONS FOR CERTIFICATE giving
OF DEATH t enter than one for each b) and (c)
oes not mean of dying, heart foilure, tc. It means . or compli- kich 56 L if any, IDe rise to cause
(.). the under- last.
ons contrib .- cath but not the terminal audition gior
Chapter 137, 954, requires s to print er cause er death oa tifcates.
SOM-3-57-920345
7 NAME OF
FUNERAL DIRECTOR_Richard C. Kirby
ADDRESS917 Bennington St.E.Boston
Received and filed AUG 2 5 495. -19 Charles H. Mackie
PERSONAL AND STATISTICAL PARTICULARS
8 SEX M
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED Married
or DIVORCED
10a If married, widowed, or divorced
Audrea Sullivan
HUSBAND, of ...
Edith.A.
(Give maiden name of wife in full)
(or) WIFE of
(Hushand's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
41years.
Months
Days
If under 24 hours
Hours ........ Minutes
13 Usua!
Occupation :
School Teacher
(Kind of work done during most of working life)
14 Industry
or Business :
Boston Schools
15 Social Security No. 021-01-4932
16 BIRTHPLACE. (City)
(State or country)
Mass.
Boston
MURTHIS
17 NAME OF
FATHER
Timothy F. SiIGA
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mass.
19 MAIDEN NAME
OF MOTIIER
Mary F. Callahan
Boston
20 BIRTHPLACE OF
MOTIIER (City)
(State or country)
Mass
21
InformantMrs.Audrea Murphy
(Address) LOMaryland Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit/permit waf issued :
(Signature of Agent of Board of Health or other)
9,24
8 - 2 2-150
(Official Designation)
(Date of Issue of Permit)
V.Bv
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Aug
(Month)
(Day)
21
1958
(Year)
4 I HEREBY CERTIFY,
1958
That I attended deceased from
8/11/ 1958.
to
8/21
I last saw hl _alive on
8/21, 1958, death is said to
2:50 Pm.
have occurred on the date stated above, at
INTERVAL
BETWEEN
ONSET AND
DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
CARDIAL FAILURE
Due To
Hypertensive Heart Diseg
(b)
Due To
Per ARTERitis Nodosce
(c)
OTIIER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
yes
.
What test confirmed diagnosis? BIOPSY
PM
5 Was disease or injury in any way related to occupation of deceased? C
If so. specify
(Signed)
André Perron
M. D.
(Address)
Carney
Date
8/21
- 195
6 Holy Cross
-
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
Aug. 25.
1958
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
213
#7
To be filed for burial permit with Board of Health of its Agent.
Registered No.
8003
[(If death occurred in a hospital or institution, St. (give its NAME instead of street and number) No. PAUL
2 FULL NAME
(If deceased is a married, widowed or divorced woman) give als6 maiden name.)
(a) Residence.
No.
16 MaryLAND
Ave
WINthroP
(If nonresident, give city or town and State)
Length of stay: In place of death
years.
months /Odays. In place of residence
4
years.
months
days.
PLACE OF DEATH
Suffolk (County) Porchester (City or Town)
CARNEY
HOSPITAL
MURPHY
PHYSICIAN - IMPORTANT (Was deceased a
U. S. War Veteran,
if so specify WAR)
VI.W.2
(Usual place of abode)
CERTIFICATE OF DEATH
Corrected
Death. BK2 Dep
2
1958
Malden
PARENTS
Callaghan
A TRUE COPY ATTEST: Charles A. Mackie City Registrar
The Commo
.
-
ED. SECRETAR! DIVISION
CF !IN -AMI NWEALTH TA STIC.}
S.
CERTIFICA NEATH
8418
Registered No. occurred in a hospital or institution, AME, instead of street and number) 1 PHYSICIAN - IMPORTANT 4 decease.l a . War Veteran, · · ciíy WAR) W .W.1
2 FULL NAME
Augustine s. Gannon
(If deceased is a married, widowed or divorced woman, give also maiden name.)
26 Marion St.
St.
East Boston
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city u.
·nd 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
September
3,
1958
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
. 19
That I, oMended deceased from
viewed
I last saw h
alive on
19
death is said to
have occurred on the date stated above, at
4.30 a.M.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Acute Coronary
Ocein slou
Due To (b)
Due To (c) POST MORTEM DIAGNOSIS
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)
D.O. Melia
, M. D.
(Address) Boston Health Dan Date
9/3
1958
Winthrop
19
7 NAME OF
FUNERAL DIRECTOR
Frederick J. Magrath
.East Boston
ADDRESS
Received and filed
19
SFP_ 9 1958
Charles H1. Marker
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWEDMarried
or DIVORCED
10a If married, widowed.
Helen E. Burke
HIUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Ilushand's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE63
Years
Months
Days
If under 24 hours
Hours .... Minutes
13 Usual
Pail Commissioner
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business :
self employed
15 Social Security No ..
014-30-9377
16 BIRTHPLACE (cityChelsea, Mass. (State or country)
17 NAME OF FATHER Timothy Gannon
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Chelsea
19 MAIDEN N
OF MOTHER
Mary M. Quinn
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Roxbury
Mass
Informant
(Address) 26 Marion St. East Doston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the buriaf or transit permit was issued: 1 ·2C_1.
(Signature of Agent of Board of Health or other)
5
92 10
C
(Official Designation)
(Date of Issue of Permit)
X
IR-301A -
14
UCTIONS FOR CERTIFICATE giving OF DEATH ot enter than one for each (b) and (c)
nes not mean of dying. heart failure. Ir. It means e. or compli- ckich caused
2 As. if any. ave rise to cause
(.). the under- last.
ions contrib .- frath but not the terminal adition given
Chapter 137, 954, requires s to print or cause or f death .. tifcatea.
SOM-5-57.920345
8 1958
PLACE OF DEATH
Suffolk (County) East Boston (City or Town)
26 Marion St. No.
214
To be filed for burlai permit with Board of Health or its Agent.
PARENTS
Mass.
6 Winthrop Place of Burial or Cremation DATE OF BURIAL
Sept.
6(City or Town)
58
21
Helen E. Gannon
to
. 19
INTERVAL
BETWEEN
ONSET AND
DEATH
1 day
-8 1
A TRUE COPY ATTEST: Charles H. Mackie City Registrar
X
PLACE OF DEATH
MIDDLESEX (County)
NEWTON
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
NEWTON
(City or town making return)
Registered No.
564 215
{(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.)
15 Moore St.
St.
Winthrop Mass
(If nonresident, give city of town and State)
Length of stay: In place of death ... years. months. 4
days. In place of residence ....... .. years .. J ... months. .days.
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October 3.1958
(Month)
(Day)
(Year)
Female
10 COLOR OR RACE
White
11 SINGLE
MARRIED
WIDOWED Widow
or DIVORCED O
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.)
Essential Hypertension
Acute pulmonary edema secondary
to congestive heart failure
found .... dead
12 IF STILLBORN. enter that fact here.
13
AG
.68
Years
11
Months
3
Days
If under 24 hours
Hours.
Minutes
14 Usual
Occupation ).
Nurse Practical
(Kind of work done during most of working life)
15 Industry
or Business:
Hospital Nursing
16 Social Security No
Cannot be learned
17 BIRTHPLACE (City)
(State or country)
Boston, .... Mas.s.
18 NAME OF
FATHER
George Collins
19 BIRTHPLACE OF
Boston
FATHER (City)
(State or country)
Mass.
20 MAIDEN NAME
OF MOTHER
Margaret Howard
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston
(Address)
Waltham, Moss.
Date ... O.c.t .. . 3 ... 19 ... 58
7 Holy Cross Malden
Place of Burial, or Cremation,
Oct. 6, 1958
DATE OF BURIAL .19
8 NAME OF
FUNERAL DIRECTOR
Richard C .Kirby
ADDRESS
917 Bennington St., E.B.
NOV 1
Received and filed. 19
(Registrar of City or Town where deceased resided)
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of ... Edward Soney
(Husband's name in full)
5 Accident, suicide, or homicide (specify).
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?
Manner of
(Specify type of place)
Injury
(How did injury occur?)
Nature of
While at work?
Was autopsy performed?
No
6 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed) Peter.Angelo M. D.
PARENTS
Mass.
22 Mrs. Benadette Rouillard (Address) 15 Moore St., Winthrop, Mass. Informant
A TRUE COPY
Monte 2, Boobras
ATTEST:
(Registrar of City or Town where death occurred) October 7, 1958
DATE FILED
19
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 25m-(h)-10-48-24658 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
R-305 1
(City or Town) 36 Brandeis Rd. No. Helen V. Soney
(Collins )
(Was deceased a
U. S. War Veteran.
if so specify WAR).
No
(a) Residence. No. (Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
(write the word)
9 SEX
(City or Town)
No
1
X
PLACE OF DEATH
Middlesex
(County)
Everett
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
EVERETT
(City or town making return)
Registered No. 216
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.)
59 Winthrop
(a) Residence. No (Usual place of abode)
20
(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
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October 4. ·
1958
(Month) (Day)
(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.) Coronary Thrombosis
11a If married, widowed, or divorced
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
61
AGE
Years.
Monthe
Dris
If under 24 hours
Hours ....
Minutes
14 Usual
Occupation :
Supervisor ...
most of working life)
15 Industry
or Business:
Lyman School
16 Social Security No. -
17 BIRTHPLACE (City).
(State or country)
Boston
Mass.
18 NAME OF FATHER Frank L.
PARENTS
19 BIRTHPLACE OF FATHER (City) (State or country) M988
20 MAIDEN NAME OF MOTHER Mary Ryan
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass,
22 Informant (Address)
Margaret Ryan
Winther
A TRUE COPY:
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.