USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1959 > Part 22
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SUFFOLK
(County)
BOSTON
(City or Town)
CERTIFICATE OF DEATH BAKER MEMORIAL MASSACHUSETTS GENERAL HOSPITAL
No.
2 FULL NAME.
Stephen J. Connors
(If deceased is a married, widowed or divorced woman, give also maiden name.)
44 Quincy Ave.
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
J DATE OF
DEATH
January
30
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
Thawb attended deceased from
January 21 , 19 59 to January 30
We last saw h 1 mive on January 30. 19 59, death is said to have occurred on the date stated above, at 10: 00am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) PULMONARY EDEMA
Due To
· ARTERIOSCLEROSIS HEART
(b) -
DISEASE
2. YRS.
Due To (c)
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)
M. D.
(Address) Asst. Dir, Mass Gen'l Hoop,
Date 1-30-59
Winthrop Winthrop
Place of Burial or Cremation (City or Town)
DATE OF BURIAL February 3 159
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS
Winthrop Mass
FLB > 3 1959
Received and fles ?... Charles 95 In
. P.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
10a If married, widowed, or divorced
HUSBAND of
Esther J
Terrile
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 71 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:
Insurance
025-03-4150
16 BIRTHPLACE (City)
(State or country)
Masa
17 NAME OF
FATHER
Alphonso Connors
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Miquelon
19 MAIDEN NAME OF MOTHER Harriet Reddick
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Newfoundland
21 Esther J.Connors
Informant
(Address)
44 Quincy Ave. Finthron
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit, was Issued: Q. Mariano E 16844
(Signature of Agent of Board of Health or other)
Feb.
5
(Official Designation) (Date of Issue of Permit)
.
-
64
· To be filled for burial permft with Board of Health or its Agent, 01032
Registered No.
f(If death occurred in a hospital or institution,
St. [give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
Mo
U. S. War Veteran,
if so specify WAR)
(a) Residence.
No ..
(Usual place of abode)
ERTIFICATE
iving F DEATH eater ... ... .or each ) and (c)
hi of dving. 'art failare.
or compli-
420 if any.
atk bat sat the formina dition given
Chapter 137. 54, requires i to print er
death .. Ifcates.
.
070
1-1
11 2
PLACE OF DEATH
The Commonwealth of Massachusetts EDWARD J. CRONIN OTTT - OF - TOWN.
SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
R-301A 1
ICTIONS
(.). san. last.
INTERVAL DETWEEN ONSET AND DEATH HRS.
Insurance Agent
15 Social Security No ...
East Boston
A TRUE COPY ATTEST: Charles it mackie City Registrar
RECEIVED
TOMT
1112
.
3.
Milli
LERK
...
8
6
JUN - 21959 AM
R-39TA 1
CTIONS
ERTIFICANE
F DEATH
... ...
.. ... .... - Port failure,
(.).
lut.
.
a costris. ak bat set the terminal dition fiers
Chapter 137, 54, requires i to print er
death .. ffcates.
.
50M-1-68-921876
8
1959
PLACE OF DEATH
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
OUT - OF - TOWN
To be filed for burial permit with Board of Health or its Agent.
St. [give its NAME instead of street and number) No.
MARGARET MITCHELL
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
24 ELLIOT STREET
St
(If nonresident, give city or town and State)
Length of stay: In place of death
---- years
months
_ days. In piace of residence __ 29years ...
__ months _____ days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
FEBRUARY
5
1959
DEATH
(Month)
(Day)
(Year)
8 SEX
Female
9 COLOR
White
10 SINGLE
_ (write the word)
MARRIED
WIDOWED
of DIVORCED
AI HERERBOROPJIFY,
Feb. 4,
19
to
Feb. 5,
death is said to
have occurred on the date stated above, at
I
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Cerebral thrombosis
(a)
Due To
Cerebral arteriosclerosis
(b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
NO
What test confirmed diagnosis ?.
Clinical
S Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed) -Chillan M. D.
(Address) Acct Dle. Nora Can't Hosp. Date
2/5/ 1959
Calvary Cemetery Taltham
Place of Burial or Cremation
(City of Town)
DATE OF BURIAL Feb. 7.59 19
7 NAME OF
FUNERAL DIRECTOR Maurice_N Kirby
ADDRESS 210 Winthrop St. Winthrop
Received and filed FEB - 9 1959 _19. Charles H Linka
PARENTS
18 BIRTHPLACE OF
Ireland
FATHER (City) (State or country)
19 MAIDEN NAME
OF MOTHER
Mary Donahue
20 BIRTHPLACE OF MOTHER (City) (State or country)
Ireland
21 Richard F Mitchell
Informant
(Address)
24 Elliot St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was Aled, with me BEFORE the burial or transit permit was issued: Jmeach (Signature of Agent of Board of Health or other) 1296
2.6
(Official Designation)
(Dateof Issue of Permit)
V.P.v
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.
If under 24 hours
-Hours ___ Minutes
13 Usual
Occupation :
Clerical
(Kind of work done during most of working life)
14 Industry
or Business :
Stationary
15 Social Security No ...
Unknown
16 BIRTHPLACE (City)
(State or country)
Taltham
17 NAME OF
FATHER
Thomas D. Mitchell
.
MASSACHUSETTS GENERAL HOSPITAL
Registered No.
+1261
f(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT -
(Was deceased a
U. S. War Veteran,
WAR).
No
(a) Residence.
No.
(Usual piace of abode)
WINTHROP", MAS'S.
geçjíž
Single
My last saw Hralive on
8:26A
m.
That pattended deceased from
1959
Feb. 5,
19 59
INTERVAL
BETWEEN
ONSET AND
DEATH
12
86
30 hr
Years
Months
_ Day's
Unkn.
PERSONAL AND STATISTICAL PARTICULARS
65
or compli- hich
33'
A TRUÉ COPÝ ATTEST Charles Ht Mackie City Registrar
1
-
JUN- 81959 AM
PLACE OF DEATH
SUFFOLK
(County)
BOSTON
(City or Town)
The Commonwealth of Massachusetts - OF - TOWNGO EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH To be filed for burial permit with Board of Health or Its Agent. DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Registered No.
01418
St. [give Its NAME instead of street and number) No.
MAURICE KIRBY, JR.
2 FULL NAME
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
100 QUINCY AVENUE
St.
WINTHROP, MASS.
(a) Residence. No.
(Usual place of abode)
(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
FEBRUARY
9
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
That Pattended deceased from
Feb. 9 (4:158)
Feb. 9,
1959
WY last saw bublive on
Feb. 9,
19.22. death is said to
have occurred on the date stated above, at
8:P
.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Pulmonary Anactasis
(a)
Due To
Prematurity (2220grams)
(b)
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
What test confirmed diagnosis ?..
Autopsy
S Was disease or injury in any way related to occupation of deceased ? If so. specify ... ...
NO
(Signed) -callar M. D.
(Address)
6 2Finthop
Place of Burial or Crempion
DATE OF BURIAL
7 NAME OF Maurice 2t. Kirk FUNERAL DIRECTOR 210 Hinthrow 2 ADDRESS
FEB 12 1959
Received and fled
4. mackie (Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX M
9 COLOR
W
10 SINGLE
MARRIED
WIDOWED
Of DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE o
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
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:
15 Social Security No.
16 BIRTHPLACE (City) Winthrop Care (State or country) 17 NAME OF FATHER Maurice 21. Kirby
18 BIRTHPLACE OF
Henthop Mass.
FATHER (City). (State or country)
19 MAIDEN NAME
OF MOTHER
Pauline Marin
20 BIRTHPLACE OF MOTHER (City) ... (State or country)
Hasonouth Mass
21 Informant (Address)
Maurice H. Kirby
I HEREBY CERTIFY that a satisfactory standard cechficate of death was fled with me BEFORE the ensit permit was issued:
(Signature of Agent of board of Health or other)
3.56
2-10-59
(Offial Designation)
(Date of Issue of Permit)
X
B-501A 1
UCTIONS OR CERTIFICATE
dviag
OF DEATH it enter .... ... far each b) and (c)
D'SE
- bart
(.). the sun- me lut.
ions contrib. death but set 1 the terminal Mities ma
Chapter 137, 954, requires his ta print ar cause ar f death tilcates.
30 30 200 3-1-58-921876
26 1958
MASSACHUSETTS GENERAL HOSPITAL
f(If death occurred in a hospital or Institution,
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War. Veteran,
if so specify WAR)_
(write the word)
toSp.
PARENTS
Anat. Dir. Moes. Gen'l Hoep.
Pate 2/10/ 19 59.
WINTHROP (City or Town)
7 month
INTERVAL
BETWEEN
ONSET AND
DEATH
5hours
76.2.5
A TRUE COPY ATTEST: Charles H Mackie City Registrar
RECEIVED
TO!
1 12.
...
9
1
JUN :: 2 1959 AM
X
SUFFOLK
(County)
BOSTON
(City or Tam)
The Commonwealth of Massachusetts EDWARD J. CRONIN OUT - OF - TOWN
SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
To be filled for burial permit with Board of Health or Ita Agent.
01441
[(If death occurred in a hospital or institution, St. [give its NAME instead of street and number) No.
2 FULL NAME
XXXXXXXXXX6
John F Collins
(Was deceased a
(If deceased is a married, widowed or divorced woman, give also maiden name.)
260 MAIN STREET
St
WINTHROP, MASS.
(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.
- days. In place of residence 22 years_months days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY.
Jan. 13, 19
59
Feb. 10,
to
19.59
10a 1f married, widowed, or divorced
HUSBAND of
Mildred E Herbert
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 69Years 4 Months
20Days
If under 24 hours
Hours __ Minutes
13 Usual
Occupation:
Plant man (retired)
(Kind of work done during most of working life)
14 Industry
or Business :
Esso Standard 011 Co
15 Social Security No ....
012-09-1745
16 BIRTHPLACE (City)
(State or country)
Massachusetts
OTHER
Status post-op. gastrectomy
SIGNIFICANT
CONDITIONSfor anastomotic ulcer
11 dys
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)
@@@lan
M. D.
(Address) Aast. Dir. Moss. Gen'l Hoap. Date 2/11/19 59
Holy Cross Malden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL ...
February 13 1959
19
7 NAME OF
FUNERAL DIRECTOR
Rochard C Kirby
ADDRESS
917 Bennington St E Boston
Received and filed ........ FEB 1.3 1959 19 Charles A. Mack
PARENTS
18 BIRTHPLACE OF
CBL
FATHER (City).
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Margaret Griffin
20 BIRTHPLACE OF
MOTHER (City)
Nova Scotia
(State or country)
Canada
21
Mrs Mildred E Collins wife
Informant
(Address)
260 Main St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burjal pr tramit permit was issued :
(Signature of Agent of board of Health or other)
1365
2-11-59
(Official Designation)
(Date of Issue of Permit)
F DEATH It enter DEATH
for each >) .ad (c)
dving. wert failure.
or compli- kick caused
20.1 s.
bas contrib. rath but not the terminal dition riers
Chaptar 137, 154, requires · to print er 1 cause. er death ... tilcates.
OM-1-88-921876
2 1959
PLACE OF DEATH
R-301A I
ACTIONS
CERTIFICATE
MEDICAL CERTIFICATE OF DEATH
J DATE OF
FEBRUARY
10
1959
(Month)
(Day)
(Year)
W9 1
imlive on
Feb. 10, .19
59. death is said to
have occurred on the date stated above, at 2 : 1CP.
.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Myocardial infarct, recent
INTERVAL BETWEEN ONSET AND DEATH 2 dys
Due To
Coronary thrombosis, recent
(b)
(.).
mue lat.
Due To
Coronary artery disease,
(c) severe
Unkn. yrs .
East Boston
67
MASSACHUSETTS GENERAL HOSPITAL
STANDARD CERTIFICATE OF DEATH
Registered No.
PHYSICIAN - IMPORTANT
U. S. War Veteran,
no
if so specify WAR)
married
That'Y attended deceased from
2 dys
17 NAME OF
FATHER
Patrick Collins
A TRUE COPY ATTEST: Charles H. Mankie
RECEIVED
TOM
ERIK
6 5
JUN #21959 AM
PLACE OF DEATH
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
- OF - TOWN 68
To be filed for burial permit with Board of Health or Its Agent, 1484
BOSTON CHY I ... TILA No.
[(If death occurred in a hospital or institution, .St. (give its NAME instead of street and number)
James Chester O'Donnell
2 FULL NAMI
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran, WW#1
if so specify WAR).
(a) Residence.
No.
116 Huntington Avenue
Boston Mass.
(Usual place of abode)
Length of stay: In place of death. ........- years ... .. months. days. In place of residence
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
7h! te
10 SINGLE
MARRIED
(write the word)
or DIVORCE
Married
10a If married. widow1ºf zabeth Bergin
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
AGEO 1 _Years.
-Months.
.... Days
If under 24 hours
_Hours ... Minutes
13 Usual
Occupation:
Custodian
(Kind of work done during most of working life)
14 Industry
or Business:
Buildings
15 Social Security No.
012-09-0159
16 BIRTHPLACE (City)
(State or country)
Rhode Island
17 NAME OF
FATHER
Bernard O'Donnell
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Rhode Island
19 MAIDEN NAME
OF MOTHER
Annie T. Gleason
(Signed)
, M. D.
20 BIRTHPLACE OF
(Address) BUSivi 1 62-12-59 19
Providence
--
MOTHER (City) __
(State or country)
Rhode Island
Winthrop Winthrop Maso
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
February 14
159
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
Winthrop Mass
ADDRESS
FEB 1 7 1959 -19
Received and filed Charles H Mnaaki
e
PARENTS
21 Elizabeth O'Donnell
Informant ....
(Address)
23 Baker Road Everett Mags
I HEREBY CERTIFY that a satisfactory standard certificate of dea was filled with me BEFORE the burial au transit permit was issued: AC Laconduet
(Signature of Agent of Board of Health or other)
1412
2-13-8
(Official Designation) (Date of Issue of . Permit)
3 .- THIS IS A ANENT RECORD. Use only E APPROVED k ink or black writer ribbon, 13
STRUCTIONS FOR AL CERTIFICATE
la diving 3 OF DEATH
not eater e than ens se fer each 1, (b) and (c)
does not mean ode of dying. s heart failure. 1. etc. It Means rose, or compli- -
14.3 tions. if any. tate rue to (.). the under- last.
1
Hypertensive Heart Disease
mos
Due To (c)
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.
days.
Due To (b)
... , death is said to
have occurred on the date stated above, at
9:15 PM.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Congestive Heart Failure
hrs to
INTERVAL BETWEEN ONSET ANO DEATH
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
February 11, 1959
(Month)
(Day).
4 I HEREBY CERTIFY . XXX
Feb. 10 1959
59
to
February 11
19
(If nonresident, give city or town and State)
2.years ____ months.
days.
Registered No.
M R-301A
ditions contrib. a death but not Nto the terminal condition given
· Chapter 137, 1954, requires Dans to print er Le cause et of death on certificates. HAP. 46, 11 9 & 1AP. 114 : 45, CHAP. 3816.)
11 2 1859
Providence
A TRUE COPY ATTEST: Charles N. Mackie
RECEIVED
TOW
11 12
in
6 5
JUN 21959 AM
.301A 1
1
1959
PLACE OF DEATH
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
OUT - OF - TOWN To be filled for burlal permit with Board of Health or its Agent. 01225 Registered No
S(If death occurred in a hospital or institution .. St. ( give its NAME instead of street and number)
2 FULL. NAME
EDWARD ARMSTRONG. THOMAS
(If deceased is a married, widowed or divorced woman, give also maiden name.)
No. 43 COURT RD., WINTHROP, MASS.
(a) Residence.
(Usual place of abode)
St
(If nonresident, give city or town and State)
Length of stay: In place of death ......... years ...
2 months. ...... days. In place of residence 5.3 .. years months. .. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
FEBRUARY 18 1959
DEATH
(Month)
(Day)
(Year)
4 1 HEREBY CERTIFY.
That I attended deceased from
3 Feb
954, to Feb 17
1959
I last saw him alive on FEB 17
1959, death is said to
have occurred on the date stated above, at
6: 15 AM
INTERVAL BETWEEN ONSET AND DEATH
I week
Due To (h)
Due To (c)
Bleeding + obstructed
2 1/2 MOS.
Was autopsy performed?
No
What test confirmed diagnosis? Clinical observation
5 Was disease or injury in any way related to occupation of deceased? No If so, specify
(Signed) John R Graham M. D. (Address) FAULKNER HOSP. Date 18 Feb 1959
Winthrop Cemetery Winthrop Mass 6
Place of Burial or Cremation (City or Town)
DATE OF BURIALPournefy-80-1950 -.... .19
7 NAME OF FUNERAL DIRECTOR
ADDRESS.
174 Winthrop St Winthrop
FEB-2-5-1959 19.
Received and file. Charles 4 hacke (Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
10 SINGLE
(write the word)
malo
white
10a If married, widowed, or divorced HUSBAND of ,Esther Elizabeth KAtson
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE ... 82Years ... 9 ..... Months
.7 .... Days
If under 24 hours
Hours ......_. Minutes
13 L'sual
retired Lawyer
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
Self employed
15 Social Security No ........
82-12-0619
16 BIRTHPLACE (City) Great Village
(State or country)
Nova Scotia
17 NAME OF
FATHER
Richard Thomas
PARENTS
18 BIRTHPLACE OF FATHER (City). (State or country) Nova Scotia
19 MAIDEN NAME
OF MOTHER
Eliza Hill
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nova Scotia
21 Informant ... i.s.s.Barbara E.Thomas
(Address)
Court Road tothrow
I HEREBY CERTIF , that a Gusfactory standard certihefte of death was filed with me BEFORE the bylrial or transit permit was issued:
Mass. C. Ocoquelion
(Signature of Agent of Board of Health or other)
1503
2-20-57
(Official Designation)
(Date of Issue of Permit)
TIONS RTIFICATE
ing DEATH enter a one r each and (c)
: not mean of dying. nt failure, It means or compli- ch caused 493 if any. rise to SC
(a), · under. se last.
jis contrib- Lth but not De terminal sition given
hapter 137, 4, requires to print or cause of death .. Acates.
FAULKNER HOSPITAL
No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
NO.
if so specify WAR).
MARRIED
WIDOWED
or DIVORCED
married
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Pneumonia
OTHER
SIGNIFICANT
CONDITIONS
Gastric Ulcer
A TRUE COPY ATTEST: Charles it. Mackie City Registrar
RECEIVED
2 )
6
JUN -11959 :"
301A
IS IS A T RECORD. nly PROVED or black r ribbon.
-
PLACE OF DEATH
SUFFOLK (County) BRIGHTON (City of Town)
The Commonwealth of Massachusetts - OF - TOWN EDWARD J. CRONIN SECRETARY OF. THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
201
To be filed for burlal permit with Board of Health or Its Agent.
Registered No.
02083
St. Elizabeth Hospital
No.
MR. PATRICK J. SULLIVAN
j(If death occurred in a hospital or institution,
St. [give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
61 WALDEMAR AVE
St
WINTHROP, MASS.
(a) Residence.
No.
(L'sual place of abode)
Length of stay: In place of death .......
years ....... months
- days. In place of residence
40 years.
. months.
. days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
10a If married
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
84 ca. 8
Months
20.y.
If under 24 hours
Hours ...... Minutes
13 Usual
Occupation :
Retired Custom Inspector
(Kind of work done during most of working life)
14 Industry
or Business :
U.S. GOV
15 Social Security No.
022-01-3943
16 BIRTHPLACE (City)
(State or country)
MAAS
17 NAME OF
FATHER
John J Sullivan
18 BIRTHPLACE OF
FATHER (City)
Cork,
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER Briget Fielding
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Cork
21 Mrs Mary Brugman
Informant
(Address)
61 Waldemar Ave, Winthrop
7 NAME OF
FUNERAL DIRECTORErnest P Caggiano
ADDRESS
147 Winthrop St Winthrop
Received and filed
MAR 4 1959
harten #: Mantine
INTERVAL BETWEEN ONSET AND DEATH
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
ARTERIOSCLEROTIC HEART
DISEASE
Due To
MYOCARDIAL INFARCTION
(b)
Due To
MYOCARDIAL RUPTURE
(c)
OTHER
ACUTE PULMONARY
SIGNIFICANT
CONDITIONS
EDEMA
W'as autopsy performed?
YES
What test confirmed diagnosis?
AUTOPSY
3 W'as disease or injury in any way related to occupation of deceased ? If so, specify
(Signed)
Robert H. Quali
. M. D.
(Address)_
St. Elin Neap. Date 2/28 1959
Holy Cross 6
Place of Burial or Cremation (City or Town)
DATE OF BURIAL
March 3
19.59
I HEREBY 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)
1627
(Official Designation) (Date of Issue of Permit)
rise to (.). last.
ur conte L'A but not The Inominal
apter 137. , requires · print er cause of death on icatos.
46, 119 & 114 1945, (Đ. 3816.)
.
1 1959
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
FEB
28
1959
(Month)
(Day)
(Year)
That I attended deceased from
4I HEREBY CERTIFY.
FEB 28, 1959
to
FEB. 28
1959
I last saw h& hlive on
FEB.28,. 195, death is said to
have occurred on the date stated above, at .... 1005 A.m.
of dying. it failure,
or rompli-
420 -
ITIFICATE
ing
DEATH enter
r each and (c)
TIONS
2 FULL NAME
U. S. War Veteran,
No
( if so specify WAR)
PHYSICIAN - IMPORTANT (Was deceased a
(If nonresident, give city or town and State)
Martha Medarbey
AGE
Cambrigde
PARENTS
Malden Mass.
CERTIFICATE OF DEATH
A TRUE COPY ATTEST: Charles & Macker.
City Registrar
JUN -11959 22
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 STANDARD CERTIFICATE OF DEATH
OUT - OF - TOWN
To be filed for burial permit with Board of Health or its Agent.
Registered No.
02289
St. [give its NAME instead of street and number) No.
2 FULL NAME.
ELIZABETH PACI
(If deceased is a married, widowed or divorced woman, give also maiden name.)
16 PAINE STREET
St.
WINTHROP, MASS.
(a) Residence. No ..
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ...
_. yeara.
months
3 days. In place of residence
15 years
.. months ___ days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
MARCH
6
1959
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY. ThatHeattended deceased from
19
59
March 3, . 19_59 .. March 6,
Melast saw heralive on
March 6,
. 1952, death is said to
have occurred on the date stated above, Le 15A.
m.
INTERVAL
DETWEEN
ONSET AND
DEATH
11 IF STILLBORN, enter that fact here.
12
.AGE 7
Years
Months.
Days
If under 24 hours
-Hours __ Minutes
13 Usual
Occupation:
Housewife
(Kind of work done during most of working life)
14 yrs
14 Industry
or Business :
15 Social Security No. none
16 BIRTHPLACE (City)
(State or country)
Italy
17 NAME OF
FATHER Carmelo Daniele
18 BIRTHPLACE OF
FATHER (City) (State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Anna Tringale
20 BIRTHPLACE OF
MOTHER (City).
(State or country)
Italy
21 Informaniss Domenica Paci (Address) 16 Paine St. , Winthrop Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death filed with. me BEFORE the burjal or transit permit was issued: E1755G
(Signature of Agent of Board of Health or other) mar. 7. 1959
(Official Designation)
(Date of Issue of Permit)
X
TIFICATE
DEATH ster .... each .sd (c)
t falu.
compli-
443 -
apter 137, , requires · prist er caum of death .. cates.
COM-1-68-921876
1
1959
Received and filed Charles A MAIN". (Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
Of DIVORCED Married
10a If married, widowed, or divorced
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