USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1960 > Part 19
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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 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.
APR 1 1960 (.
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)
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.
82
No. 142 Pleasant St. ,
2 FULL NAME MaybelleG.Urann nee Merrill
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
82 Arlington Ave.,
St
Revere
(If nonresident, give city or town and State)
Length of stay: In place of death
.years
months
days. In place of residence.
5 5ears ...._... months.
..._. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
female
white
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWEDWidowed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Walter Urann
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 89 Years.
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.
none
16 BIRTHPLACE (City)
(State or country)
Lynn Mass.
|17 NAME OF
FATHER
James Merrill
18 BIRTHPLACE OF
FATHER (City)
(State or country)
N.H.
19 MAIDEN NAME
OF MOTHER
Sara Tate
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Me.
6 Woodlawn
Everett (City or Town)
Place of Burial or Cremation
DATE OF BURIAL
April 12,1960
19
7 NAME OF
FUNERAL DIRECTOR
J. Vincent Murray
ADDRESS Revere Mass.
Received and filed. APR 13 1960 19
(Registrar)
21
Informant
E
Archer Moulton
(Address)
82 Arlington Ave., Revere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Hallal Sereaux.D- (Signature of Agent of Board of Health or other)
Health Officer
4/12/60
(Official Designation) (Date of Issue of Permit)
UCTIONS FOR CERTIFICATE giving OF DEATH ›t enter than one for each b) and (c)
bes not mean of dying, heart failure, tc. It means , or compli- hich caused
ss, if any, ive rise to ause (a), the ause under- last.
ons contrib -- cath but not & the terminal isdition given
Chapter 137, 54, requires ; to print or cause or death on elficates.
50M-11-56-918978
3 DATE OF
DEATH
April 9 1960
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
That I attended deceased from
1945,
to ..
april
9
19.60
I last saw h ___ alive on
gail 8
, 19 60 death is said to
have occurred on the date stated above, at
11 P .m.
INTERVAL
BETWEEN
ONSET AND
DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
arteriosclerosis
(a)
Arteriosclerosis
Due To (b)
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. Denis O'Reilly
(Signed).
M. D.
(Address).
19/
PARENTS
Registered No.
[(If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and numher)
PHYSICIAN - IMPORTANT
‹ ‹Was deceased a
U. S. War Veteran,
no
if so specify WAR)
(Usual place of abode)
3 -4
NEVER.
[ R-301A 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.
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 derk 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. APR. 1
(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
Middlesex (County) Cambridge
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
&ament aafg this return)
Registered No.
604
83
§(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME Joseph J . Dalton
(If deceased is a married, widowed or divorced woman, give also maiden name.)
76 Atlantic
Winthrop, Massachusetts
St
(If nonresident, give city or town and State)
Length of stay: In place of death.
.. years
.. months.
24
40
.days. In place of residence
ears
months.
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April 11, 1960
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
March 28
60
April 11
OH-
19
I last saw h-Lalive on
19
April 10
19.
death is said to
2:30a.
m.
have occurred on the date stated above, at
INTERVAL BETWEEN ONSET AND DEATH
Due Reticulum Cell Sarcoma (b) with Generalized Metastases
OTHER SIGNIFICANT CONDITIONS
no
Was autopsy performed?
What test confirmed diagnosis ?.
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify.
Frank A. Pomer
M. D.
(Address)
Date
19
Winthrop Cemetery winthrop
Place of Burial or Cremation April 13,
(City or Town)
60
19
DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS Winthrop, Mass .
Received and filed. MAY - 1960 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX ale
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEarried
10a If married, widows
HUSBAND of
Atihle L.
divorced
Emmett
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE.79
Years
Months.
.. Days
If under 24 hours
Hours ........
Minutes
13 Usual
Retired Salesman
Occupation :
(Kind of work done during most of working life)
14 Industry
Food
or Business :
15 Social Security No ...
16 BIRTHPLACE (City)
Chelsea
(State or country)
Mas3.
17 NAME OF
FATHER
Joseph W. Dalton
18 BIRTHPLACE OF
FATHER (City) (State or country) Ireland
19 MAIDEN NAME
OF MOTHER
Catherine A. Dalton (ok)
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21 Annie L. Dalton
Informant:
76 Atlantic St. Winthrop
A TRUE COPY Irévérend? ist Burke,
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED Apr. 11, 1, 50
C. V.A.
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
6 resided as soon as possible, after the close of the month in which the death occurred. (Scc Chap. 46, Sec. 12, G. L.) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c)
25M-8-56-918227
(Signed)
Holy Ghost Hosp.
4/11
60
PARENTS
M R-302 1
No. Holy Ghost Hospital
(a) Residence.
No.
(L'sual place of abode)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(write the word)
60
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)Bilateral Bronchopneumonia
MAY -1960 AM
X
PLACE OF DEATH
Suffolk
(County) Winthrop
(City or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
84
Anthony Paolini
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
525 Pleasant
St.
Winthrop, Mass.
(a) Residence. No.
(Usual place of abode)
6
(If nonresident, give city or town and State)
Length of stay: In place of death
6
... years
.. months .............. days. In place of residence.
.years .....
months ............
.... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR
white
10 SINGLE
MARRIED
WIDOWED married
or DIVORCED
(write the word)
DEATH
(Month)
(Day)
(Year)
4
Į
HEREBY
CERTIFY,
That I attended deceased from
Feb 2
1960
to ..
april 11
1960
I last saw hemmalive on
april
11
, 1960
death is said to
have occurred on the date stated above, at
10:30Am.
INTERVAL BETWEEN ONSET AND DEATH
Due To (b)
Due To (c)
OTHER
Cesvan Atu
SIGNIFICANT
CONDITIONS
Asian
If/v.
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)
G. GUY/ GRANDE
buy grandethy M. D.
(PRINT OR TYPE SIGNATURE) MAS
(Address) 20 SARATOGA di. GAZI ... Date .... 4-13 1960
6
Holy Cross Cemetery Malden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 14,
19.60
7 NAME OF
FUNERAL DIRECTOR
Anthony P. Rapino
ADDRESS
9 Chelsea St. East Boston, Mass.
Received and filed APR 14 1960 19
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Lucia DiProfio
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
Mildred Paolini (wife)nthrop
21
Informant
(Address)
525 Pleasant St., East Boston, Mass
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) Healthy Oficer 4/13/60
(Date of Issue of Permit)
(Official Designation)
UBV
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each b) and (c)
es not mean of dying, heart failure, etc. It means , or compli- hich caused
ns, if any, ave rise to ause (a), the under- ause last.
tions contrib- eath but not the terminal ndition given
Chapter 137, 54. requires s to print or cause or death on ificates. and 48, Acts of Quires Physi- rint or type r signature.
4-59-925686
11 IF STILLBORN, enter that fact here.
12
51
AGE
Years.
.Months ..
Days
If under 24 hours
Hours.
.Minutes
13 Usual
Occupation :
Truck Driver
(Kind of work done during most of working life)
14 Industry
or Business :
United-Carr Fastener Corp.
15 Social Security No.
020-07-8345
Boston
16 BIRTHPLACE (City)
(State or country)
Mass.
17 NAME OF
FATHER
Donato Anzelmo Paolini
·1
(Give maiden name of wife in full)
(or) WIFE of
10a If married, widowed, or divorced
HUSBAND of
Mildred P. Nania
(Husband's name in full)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Coronary infarct
(a)
Coronary Infarcte
PENSE
No.
525 Pleasant Street
[(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,
no
[if so specify WAR)
To be filed for burial permit with Board of Health or its Agent.
R-301A 1
3 DATE OF
April 11, 1960
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following 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 un- related 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 occu- pation, 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 impor- tant, 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. Chil- dren 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.
6
APR 1 4:1960 Mi
×
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
WINTHROP COM, HOSP
The Commonwealth of Massachusetts JOSEPH D WARD 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.
85
S(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Irene (Lavoie) White
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 2.Deane Ave .... Winthrop ( Usual place of abode)
St.
+If nonresident, give city or town and State)
Length of stay: In place of death. ...... ..... years. months 2 days. In place of residence 0 years. months .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
April
12
1960
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
May
1957
to 4prl 12
That I attended deceased from
19.60
I last saw Hey alive on
april
12, 1966, death is said to
have occurred on the date stated above, at
3:52 Pm.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
Broncho pneumonia
(a)
(Termina)
INTERVAL
BETWEEN
ONSET AND
DEATH
48 hrs
11 IF STILLBORN, enter that fact here.
12
AGE 45 Y
„Years ...
... Months.
Days
If under 24 hours
Hours ..............
Minutes
Due To
Carcinoma of
- (b) Lung (undifferentiated)
Due To
(c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
What test confirmed diagnosis ? 19,apsy
5 Was disease or injury in any way related to occupation of deceased? 120 If so, specify GRE60KIC
(Signed) naeple preçone M. D.
119 & Washington are (PRINT OR TYPE SIGNATURE) (Address) 194 Wash Myhrer Date 4-13
6 WINTHROP WINTHROP
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL APRIL 15 1960
7 NAME OF
FUNERAL DIRECTOR
Manuel W Linky
ADDRESS HI WINTHROP ST WINTHROP
Received and filed APR 14-1960
(Registrar)
PARENTS
QUEBEC.
18 BIRTHPLACE OF
FATHER (City)
(State or country)
CANADA
19 MAIDEN NAME
OF MOTHER
COSE ANNE MURPHY
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
MAINE
21 Informant (Address)
2 DEHNE AVE WINTHROP
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Malkle C. Percounty
(Signature of Agent ff Board of Health or other),
Healthe Series 4/14/60
(Official Designation)
(Date of Issue of/Permit)
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