Town of Winthrop : Record of Deaths 1960, Part 25

Author: Winthrop (Mass.)
Publication date: 1960
Publisher:
Number of Pages: 596


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1960 > Part 25


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


50M-9-59-926111


X PLACE OF DEATH


.... (County ) Danvers


The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Danvers


( City or Town making this return)


111


.Danvers .... State .... Hosp ......... fathorno, ...... last.s .give its NAME instead of street and number) No.


2 FULL NAME Finn, Anna P. (Anna F. Gunn)


( If deceased is a married, widowed or divorced woman, give also maiden name.)


10 .... Palmyra .... S.t. ......


St .......... Tinthro (If nonresident, give city or town and State)


Length of stay: In place of death 3 years. 5 months 22 days. In place of residence ......... years.


.. months .......... days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


May


( Month)


(Day )


( Year)


8 SEX


Female


White


10 SINGLE


( write the word)


MARRIED


WIDOWED


or DIVORCEDHarried


4 I HEREBY CERTIFY.


That


attended deceased from


Mcr. 12, 19.56, to ...


Jay.4,


I last saw h .. C.tive on


May 4


1960, death is said to


have occurred on the date stated above, 1:20a. .. m.


INTERVAL BETWEEN ONSET AND DEATH


(or) WIFE of .... WilliamJ ...... Finn.


[Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


1 monthAGE7.O ... YearsL.O .. Months.211.Days


If under 24 hours


.Hours ........ Minutes


13 Usual


Occupation:


Housewife


(Kind of work done during most of working life)


14 Industry


or Business :


15 Social Security No.


Unknown


16 BIRTHPLACE (City)


(State or country )


Boston, Hass.


OTHER


SIGNIFICANT


CONDITIONS


Eponchopneumonia .. days


Was autopsy performed ?


No


What test confirmed diagnosis ?


Clinical & Lab.


5 Was disease or injury in any way related to occupation of deceased ? If so, specify


( Signed )


Ruth M. Crossfield


M. D.


( Addre


Hathorne., .... Mass .....


Date ...


5/4/


1960


Winthrop Com.


Winthrop, Mass.


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


Ma.y ..... 9.,


19.60


7 NAME OF


FUNERAL DIRECTOR


Morris W. Kirby


ADDRESS Winthrop, Mass.


Received and filed JUN 10 1960 19


( Registrar of City or Town where deceased resided)


PARENTS


19 MAIDEN NAME OF MOTHER Mary Ellen Waters


20 BIRTHPLACE OF


MOTHER (City)


( State or country)


Mass.


Mary L. Sheehan


21


Informant


( Address)


Hathorne, Lass.


A TRUE COPY


Daniel J. Toomey


ATTEST :


( Registrar of City or Town where death occurred )


Hay 4,


60


... 19.


DATE FILED


1


(City or Town)


Registered No.


S (If death occurred in a hospital or institution,


( Was deceased a


U. S. War Veteran.


if so specify WAR ......


Nio


(a) Residence. No ( Usual place of abode)


4.


1960


19.60 ...


10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE (a) Cerebral thrombosis ......


GeneralizedArteriosclerosis


yrs.


17 NAME OF


FATHER


James T. Gunn


18 BIRTHPLACE OF


Boston, Mass.


FATHER (City)


(State or country )


Boston


5.


9 COLOR


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER


JUN 1 01960 /1


I R-301A 1


RUCTIONS FOR I CERTIFICATE


I giving IOF DEATH Dot enter s than one n for each 0(b) and (c)


es not mean IL of dying, s heart failure, atc. It means se?, or compli- hich caused


stas, if any, have rise to e ause (a), ng'he under- Pause last.


mions contrib- beath but not I the terminal dition given


hapter 137, 54. requires ; to print or tr


cause or death on ficates, and 8, Acts of ires Physi- int or type r signature.


- 9-925686


PLACE OF DEATH


SUFFOLKL (County) WINTHROP (City or Town)


The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


-


f. \ give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


[(Was deceased a ¿ U. S. War Veteran, (if so specify WAR) NO


(a) Residence. No. (U'sual place of abode)


Length of stay : In place of death .. .... ..


.. years ...... . .. months


/ days. In place of residence 46 years. months days.


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


FITMALL


9 COLOR


WHITE


10 SINGLE


MARRIED


WIDOWED


V DOUVED


4 I HEREBY


CERTIFY, That I attended deceased from


Feb


1960, to.


MAY


60


19.


I last saw he Yalive on


May


4


19.


60


death is said to


have occurred on the date stated above, at 11:45 Pm.


INTERVAL


BETWEEN


ONSET ANO


(a)


DEATH


6 hrs


10a If married, widowed, or divorced


HUSBAND of


JOSEPH Y MINAHAN.


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE.


70 Years.


Months.


.Days


If under 24 hours


Hours.


.........


Minutes


13 Usual


Occupation :


JusquitE


(Kind of work done during most of working life)


14 Industry


or Business :


110 MF


15 Social Security No.


WICHERN DON


17 NAME OF


FATHER


JUHTil EAGAN


18 BIRTHPLACE OF


LEOMININSTER


FATHER (City)


(State or country)


MASS


19 MAIDEN NAME


M. D.


OF MOTHER


MARY EVANS


20 BIRTHPLACE OF


MOTHER (City)


CHICOPEE


(State or country)


MASS


21


Informant


(Address)


JOHN MUNALIAN


HERMON ST WINTHROP


---


IHEREBY


CERTIFY that a) satisfactory standard certificate of death


was /filed with me BEFORE the burial or transit permit was issued:


Calleh . Sureanu


(Signature of Agept of/Board of Health_orother)


Health Officer


5/6 /60


(Date of Issue of Permit)


(Official Designation)


PARENTS


(Signed)


Charles


Charles Liberman


(PRINT, OR TYPE SIGNATURE)


(Address)


Winthrop,


Date ....... ......... 5/6/1960


6


WINTHROP


Place of Burial or Cremation


(City or Town)


WINTHROP.


DATE OF BURIAL


MAY 1


160


7 NAME OF


MAURICE WV KIRBY


FUNERAL DIRECTOR


ADDRESS WINTHROP


Received and filed MAY-6 -1960 19


(Registrar)


2yrs


Due To


Coronary Artery Heart


(b)


Disease


Due To


Anemia, Mipochromic


(c)


Normo@ytic


OTHER


SIGNIFICANT


CONDITIONS


-


Was autopsy performed?


NO


What test confirmed diagnosis ?


Clinical


5 Was disease or injury in any way related to occupation of deceased ? VO If so, specify


To be filed for burial permit with Board of Health or its Agent.


112


Registered No.


MOUNTS REST HOME HIGHLAND ALE! ELLEN I. MONAHAN EAGAN


2 FULL NAME


(If deceased is a married, widowed or divorced woman, give also maiden name.) 17 TRWIN ST St. (If nonresident, give city or town and State)


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


(Month)


(Day)


MAY


4


1960


(Year)


(write the word)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Coronary Occlusion


Heutle


6 mos


16 BIRTHPLACE (City)


(State or country)


V


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


-10


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 duringla Tast)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.


X PLACE OF DEATH


Suffolk (County) 37213!


Winthrop (City or Town)


Winthrop Community Hospital No.


f(If death occurred in a hospital or institution,


St. Į give its NAME instead of street and number)


PHYSICIAN - IMPORTANT [(Was deceased a { U. S. War Veteran,


(if so specify WAR)


(If deceased is a married, widowed or divorced woman, give also maiden name.)


31 Elmwood St., Revere


St.


(If nonresident, give city or town and State)


Length of stay: In place of death .. . .. . . years ......


. months


.days. In place of residence.


......


.years ..


months.


.days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


.5


1962.


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


5 5


19 60, to


M 0.1


5


1960


I last saw h.l.Malive on


E


mar


5


1960, death is said to


have occurred on the date stated above, at 12:15 p.m.


INTERVAL


BETWEEN


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


ONSET AND


DEATH


(a)


STILL BORN SONGS2 til


ATCjiTa-15


Due To (b)


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


No


What test confirmed diagnosis ?


5 Was disease or injury in any way related to occupation of deceased ? If so, specify


(Signed)


Marion C Scotia


M. D.


MARION C. SABIA


(PRINT OR TYPE SIGNATURE) CM


(Address) 24) marerit S. Da Date May 5 1964


6


Holy Cross Cemetery malden


(City or Town)


Place of Borial or Cremation


DATE OF BURIAL


may 6,


19.60


7 NAME OF


FUNERAL DIRECTOR


Paul Buonfiglio


ADDRESS 128 Severe Le Severe


Received and filed


May 27 1960


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Male


9 COLOR


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


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.


Statham


12


AGE ..


Years.


.......


.. Months


Days


If under 24 hours


Hours 115


.Minutes


13 Usual


Occupation :


(Kind of work done during most of working life)


14 Industry


or Business :


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Winthrop, Mass.


17 NAME OF


FATHER


Canadido Spacone


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER Concetta Lavillotti


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


21


Informant


(Address)


Candido


Spacone


3) Elmwood It Bevere


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


(fallto pieces


15/6/60


(Date of Issue of Permit>


U


|(Official Designation)


1


1 R-301A 1


RUCTIONS FOR CERTIFICATE


J giving OF DEATH o ot enter M than one u for each (b) and (c)


es not mean .? of dying, I heart failure, aetc. It means see, or compli- which caused


dins, if any, have rise to e cause (a), ngthe under- g ause last.


on ions contrib- to eath but not A the terminal Isdition given


Chapter 137, of 54. requires cits to print or tl cause or death on ceificates, and er 8, Acts of re :ires Physi- torint or type un r signature.


M-59-925686


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.


113


Registered No.


2 FULL NAME Spacone, Baby Boy


(a) Residence. No. (l'sual place of abode)


45 MiAl.


PARENTS


--


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


1.


6


1ROR


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.


MAY 271960 AM


× PLACE OF DEATH


Suffolk Dunty


is


SE


The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


Registered Vo .


114


No. Winthrop Convalescent Home


2 FULL NAME Generoso Repucci


(If deceased is a married, widowed or divorced woman, give also maiden name.)


63 Monmouth St.


East Boston


St


'li nonresident, give city or town and State)


Length of stay : In place of death .......... .. years .........


.months.


3


days. In place of residence / Oyears.


months


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


male


9 COLOR


white


10 SINGLE


MARRIED)


WIDOWEDOwed


or DIVORCED


(write the word)


3 DATE OF


DEATH


May


3,


1960


(Month)


(Day)


(Year)


That I attended deceased from


I last saw h.l.m.alive on


MAY


ـل


19.6.6


death is said to


have occurred on the date stated above, at


6 30 pm.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


1ª CARCINOMA of Prostate


Due To (b)


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


SENILITY


YPS.


Was autopsy performed?


NO


What test confirmed diagnosis ?


PATL. LAB .- M.G.H.


5 Was disease or injury in any way related to occupation of deceased ? Y.O. If so, specify


4 2. Thomas Stoffer


(Signed)


Thomas Staff


19 Breaking OR TYPE SIGNATURE) May 9. Date


1960


6


Holy Cross


Malden


Place-of Buriat or Cremation May 11


(City or Town) 60


19


7 NAME OF


FUNERAL DIRECTOR


Frederick J. Magrath


ADDRESS 43 Jaldemar Ave. S. Boston


Received and filed MAY 9 1960 19


(Registrar)


PARENTS


18 BIRTHPLACE OF


FATHER (City) (State or country)


19 MAIDEN NAME


Mary Coppola


M. D.


OF MOTHER


20 BIRTHPLACE OF MOTHER (City) (State or country)


21 Alfred Hepucci


Informant


(Address)


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 ethers


Health office 5/9/60


(Official Designation)


(Date of Issue of Permit)


X


10a If married,


obsdyrene Moschella


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


INTERVAL


11 IF STILLBORN, enter that fact here.


BETWEEN


12


93


ONSET AND


DEATH


1955


Years ..


Months


Days


If under 24 hours


Hours


Minutes


13 Usual


Occupation :


expressman


(Kind of work done during most of working life)


14 Industry


or Business :


retired


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Italy


17 NAME OF


FATHER Arcangelo Renucci


on'ions contrib- to eath but not t the terminal adition given


e: Chapter 137, of 54. requires cias to print or tl cause or death on ceificates, and er 18, Acts of retires Physi- rint or type ·r signature.


M-59-925686


1time


I R 301 - 1


2- 6.30PM


1


RUCTIONS FOR I CERTIFICATE


a Residence. No.


. [ sual place oi abode )


f(If death occurred in a hospital or institution,


St Į give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


[(Was deceased a { U. S. War Veteran, [if so specify WAR)


no


4 I HEREBY CERTIFY,


OCTOBER


59


to.


MAY 8


19


66


To be filed for burial permit with Board of Health or its Agent.


Winthrop (City of Town)


DATE OF BURIAL


(Address)


di.ns, if any, have rise to etause (a), nithe under- g ause last.


jes not mean Bt? of dying, usheart failure, aetc. It means see, or compli- which caused


1 giving JOF DEATH o ot enter i than one u for each )(b) and (c)


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER


RULES OF PRACTICE 1.01 -


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 rece.it 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 pur uits 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.


.


IM R-303 1


D-WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of of Death. See reverse side for additional information. See also Chap. 38, §§ 6, 20; Chap. 46, §§ 9, 10; Chap. 114, DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF


If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.


35M-11-59-926662


PLACE OF DEATH


Suffolk (County)


Boston (City or Town)


The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH


To be filed for burial permit with Board of Health or its Agent.


Registered No.


115


No. en route to Winthrop Community HogyIf death occurred in a hospital or institution. gove its NAME instead of street and number)


2 FULL NAME


WILLIAM M. MCLAUGHLIN


(If deceased is a married, widowed or divorced woman, give also maiden name.)


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


WW II


(if so specify WAR)


(a) Residence. No.


149 Bowdoin Street .


St


Winthrop,


Masso


(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


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


May


10


1960


(Month)


(Day)


(Year)


9 SEX


male


10 COLOR


white


11 SINGLE


MARRIED


WIDOWED)


or DIVORCED


(write the word)


married


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 sclerosis;


11a If married, widowed, or divorced


HUSBAND of


Magorie .N.


Nelson


(Give maiden name of wile in full)


(or) WIFE of


(Husband's name in full)


12 IF STILLBORN, enter that fact here.


AGE


Years


Months.


9


Days


Hours .


.Minutes


Date and hour of injury 19


IF ACCIDENTAL, was injury causally related to the death ? 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 ?


(Specify type of place)


Manner of


Injury


(How did injury occur ?)


Nature of


Injury


While at work ?


Yes


Was autopsy performed?


No


6 Was diseres or injury in any way related to occupation of deceased? If so, speciy


(Signed


Michael A. Luongo, M. D.,


(Print or Type Signature)


M. D.


(Address) Boston, Mass. Date 5/10 .19.60


Winthrop Cemetery, Winthrop 7


Place of Burial, or Cremation. (City or Town)


DATE OF BURIAL May 13,


8 NAME OF


FUNERAL DIRECTOR


Ernest C. Caggiano


ADDR


147 Winthrop St., Winthrop


Received and filed


MAY 12-1960


19


PARENTS


19 BIRTHPLACE OF


Madison


FATHER (City)


(State or country)


Indiana


20 MAIDEN NAME


OF MOTHER


Nora Feeney


Galway


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


22 Informant (Address) 149 Bowdoin St. ,Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was Aled with me BEFORE the burial or transit permit was issued :


(Signature of Agent of Board of Health or other) Hedlea Officer 5/12/60


(Official Designation) /


(Date of Issue of Permit)


If under 24 hours


13


46


4


14 Usual


Occupation :


Police Officer


(Kind of work done during most of working life)


15 Industry


or Business :


Town of Winthrop


16 Social Security No.


032-09-3410


17 BIRTHPLACE (City)


(State or country)


Mass.


Winthrop


18 NAME OF


FATHER


William H. Mclaughlin


Mrs. Marjorie N. Mclaughlin


§§ 44-48.


IV. 4.5 .


5 Accident, suicide, or homicide (specify)


Acute myocardial infarction.


M


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE October .. 23,.1942


DATE OF DISCHARGE


May 27, 1946


RANK, RATING


Boatswain's Mate second class M-1


ORGANIZATION AND OUTFIT


U .... S .... N ... R.


400 41 56


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 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. MAY 1,21960


(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 poison) 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


Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a collision of railroad train and automobile." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic for (enter name of operation and disease or condition requiring surgery)." "Fracture of the skull with associated internal injury sustained under circumstances unknown."




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