Town of Winthrop : Record of Deaths 1960, Part 27

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1960 > Part 27


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PLACE OF DEATH


Suffolk ( minty


Winthrop (City or Town)


0.7-857


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


STANDARD CERTIFICATE OF DEATH


Registered Vo


f(If death occurred in a hospital or institution, St | give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


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


215 Leyden


East Boston St


(If nonresident give city or town and State)


Length of stay : In place of death.


years ..


3


months.


......... days. In place of residence


......... years.


..


.. months


days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


May


23,


1960


8 SEX


female


9 COLOR


white


10 SINGLE


(write the word)


MARRIED


WIDOWERridowed or DIVORCEN


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Anthony Favello


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


79


AGE


Years


Months ...


... Days


Hours ........


Minutes


13 Usual


Occupation :


housework


ife


14 Industry


or Business :


own home


15 Social Security No.


16 BIRTHPLACE (City) ..... Boston, ...... Masso (State or country)


17 NAME OF


FATHER


John Dondero


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


unknown


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


Italy


21 Louis Favello


Informant (Address) 20 Waldemar Ave. E. Boston


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Thatkee Pereanne.D (Signature, of Agent of Board of Health or other)


Health & Rice 5/23/60


(Official Designation)


(Date of Issue of Permit)


TRUCTIONS FOR CI CERTIFICATE


1 giving IOF DEATH


o ot enter o1 than one u for each a)(b) and (c)


les not mean Be' of dying, as heart failure, jaetc. It means see, or compli- which caused


di.ns, if any, chave rise to re pause (a), mithe under- g ause last.


m'ions contrib- lo cath but not 1 the terminal usdition given


Chapter 137, 54. requires s to print or -


cause or death on Beificates, and r .8, Acts of elires Physi- o rint or type nr signature.


6


Place of Burial or Cremation


DATE OF BURIAL


May


25


19


7 NAME OF


Frederick J. Magrath


FUNERAL DIRECTOR


ADDRESS 5 Waldemar Ave. E. Boston


Received and filed -MAY-24-1960 19.


(Registrar)


PARENTS


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


thedanh ofegen M. D.


Frederick B. O) Resal


Date. 113 Plea SBRINT ORTYPESIGNATURE5, 23 (Address)


5g


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed ?


0


What test confirmed diagnosis ?


INTERVAL


BETWEEN


ONSET AND


DEATH


3 DAYS


Due To ARTERIOSCLERUTIC (b)


HEART DISEASE


That I attended deceased from


11 u 23


19


60


I last saw n. ... alive on


5/2.3


, 1960,


death is said to


have occurred on the date stated above, at ....


6.30 Am.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


BRONCHO-PNEUMONIA


(a)


CERTIFY,


4 I HEREBY 1/1 58,10


(Month)


(Day)


(Year)


Nellie Favello


2 FULL NAME.


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


(a) Residence No. (I sual place of abode)


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


121


Mayflower Nursing Home


No.


AI R-301A 1


I-59-925686


Everett (City or Town) 60


19 60


PERSONAL AND STATISTICAL PARTICULARS


1f under 24 hours


(Kind of work done during most of working life)


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 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 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.


1.1


MAY 2 4 1960 AN


X


PLACE OF DEATH


1.30X


(County)


1


Tonvors


(City or Town)


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


Dangers


(City or Town making this return)


122


Registered No.


State Hore, Hathorne, Lass . (If death occurred in a hospital or institution, give its NAME instead of street and number)


Ceix, Marion


2 FULL NAME


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


U. S. War Veteran,


if so specify WAR


lus Grandview Avenue


St


Winthrop, Lacs.


(If nonresident, give city or town and State)


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


2


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


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


( Month )


(Day)


( Year)


from


I last saw h.


Galive on


Q7 23,


19.


.. , death is said to


1000


have occurred on the date stated above, at


7:45am


INTERVAL BETWEEN ONSET AND DEATH


11 IF STILLBORN, enter that fact here.


12


,70


AGE ...


Years ..


.Months ..


Days


1


If under 24 hours


.. Hours ........ Minutes


13 Usual


Occupation :


Natimed Bookkeeper


(Kind of work done during most of working life)


14 Industry


or Business :


15 Social Security No.


016-03-5858


16 BIRTHPLACE (City)


(State or country)


DOCten


17 NAME OF


FATHER


Icil Seix


18 BIRTHPLACE OF


Un' nômm


FATHER (City)


( State or country )


Ireland


19 MAIDEN NAME


OF MOTHER


Mary Young


20 BIRTHPLACE OF


Un' nown


MOTHER (City)


Ireland


(State or country)


Mary . Shechan


21 Informant ( Address ) thorne, Dass.


A TRUE COPY


Posily Toomey


ATTEST :


Received and filed


JUN 10-1960


.19


( Registrar of City or Town where deceased resided )


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


white


1


10a If married, widowed, or divorced


HUSBAND of


( Give maiden name of wife in full )


(or) WIFE of ...


( Husband's name in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Corobial Arteriosclerosis


(a)


with


Due To


Arteriosclerotic Heart


(b)


Disease


Due ToConerulized Arterioscler- (c)


OSIS


years


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed ?


yes


What test confirmed diagnosis ?


antoncy


5 Was disease or injury in any way related to occupation of deceased ?


If so, specify


Androw Nichols, III


(Signed) Hat Horne, Dass,


M. D.


( Address ) .Date. 5/237,60


Holy Cross Cen. aniden, .1css.


Place of Burial or Cremation


(City,


May 27,


>Town) 60


DATE OF BURIAL


7 NAME OF


FUNERAL DIRECTOR


Bernard I. Lullin


ADDRESS


Waltham, Mass.


5.


resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12. G. L.)


50M-9-59-926111


Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town


THIS IS A PERMANENT RECORD


at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased


23,


1960


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Cinrle


4 I HEREBY


March


CERTIFY.


-19


to.


Thata .I attended


"lay 23,


deceased


19


years


PARENTS


19


(Registrar of City or Town where death occurred )


DATE FILED


May 31,


.19.60


RM R-302


No ... Denvor


( Was deceased a


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


SPACE FOR ADDITIONAL INFORMATION


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


1


X PLACE OF DEATH 1


1


Suffolk (County )


Winthrop (City or Town) Winthrop Community Hosp. No.


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.


123


f(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)


2 FULL NAME


Thomas Hogan


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


(a) Residence. No.


193 Everett Street


( U'sual place of abode)


St.


East Boston, 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


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


male


9 COLOR


white


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Marrie


I HEREBY CERTIFY


au !


1959


to ...


May 26


60


I last saw h ... Mlive on


May. rb,


, 1960, death is said to


have occurred on the date stated above, at


N/A.m.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


Acute Pulmonary EdEinq


(a)


INTERVAL


BETWEEN


ONSET AND


11 IF STILLBORN, enter that fact here.


12


DEATH


2 days


67


AGE.


Years


Months ..


Days


If under 24 hours


Hours. .Minutes


13 Usual


Occupation :


Porter


(Kind of work done during most of working life)


14 Industry


or Business :


Retired


15 Social Security No.


023-10-5816


16 BIRTHPLACE (City)


(State or country)


Ireland


17 NAME OF


FATHER


John Hogan


18 BIRTHPLACE OF FATHER (City) (State or country) Ireland


19 MAIDEN NAME


M D. OF MOTHER Catherine Ryan


20 BIRTHPLACE OF MOTHER (City) ¿.. (State or country) Ireland


Anastasia Horan


21


Informant


(Address)


193 Everett St. E. Poston


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


(Signature of Agent of Board of Health of other)


Health Afec 5/27/60


(Official Designation)


(Date of Issue of Permit)


UCTIONS OR CERTIFICATE


giving OF DEATH ot enter than one for each ,b) and (c)


e's not mean of dying, Heart failure, tc. It means e, or compli- hich caused


lis, if any, ve rise to use (a), the under- use last.


-


Hypertension


2yrs


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


No


What test confirmed diagnosis ?


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


(Signed)


19


George. It. Schwarte M.D


(Address) 19 Primkayastr Date ....


BRINT OR TYPE SIGNATUS 26 2,60


6 HolyCross


Malden


(City or Town)


Place of Burial or Cremation


DATE OF BURIAL


May 30,


,60


7 NAME OF


FUNERAL DIRECTOR


Frederick J. Magrath


ADDRESS


East ..... Boston, ..... Mass ..


May 27, 1960


Received and filed


(Registrar)


2 yrs


(b)


Due To


Chronic Myocarditis


Due To


(c)


May


26.


60


(Month)


(Day)


(Year)


That I attended deceased from


10a If married, widowed, or divorced


HUSBAND of


Anastasia Ryan


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


-


ra ons contrib- ath but not the terminal c dition given


hapter 137, 164. requires to print or a h cause or death on erficates, and 1 3. Acts of res Physi- int or type signature.


9-925686


5 3021-66 18:60% 2600


-


Registered No.


PHYSICIAN - IMPORTANT [(Was deceased a { U. S. War Veteran, [if so specify WAR) No


3 DATE OF


DEATH


PARENTS


--


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


6


MAY 2 71960 PM


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.


1


R-301A I


TICTIONS OR L'ERTIFICATE


living F DEATH


r: enter ehan one e or each ›) and (c)


ds not mean d of dying, art failure, c. It means 4sor compli- tich caused


ic, if any, De rise to use (a), ge under- Rase last.


dims contrib- oth but not to he terminal co ition given


apter 137, 1!1. requires anto print or he cause or o: death on er cates, and r , Acts of eqi es Physi- ) Ent or type ndrsignature.


-6- - 925686


PLACE OF DEATH


Suffolk (County)


Winthrop


(City or Town)


15-60


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.


124


2 FULL NAME


John Coleman


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


313 Meridian St.


St.


East Boston


(a) Residence. No.


(Usual place of abode)


(If nonresident, give city or town and State)


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


-


.. months


2


16


days. In place of residence


.years


months


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


5


29


1960


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


MAX 25


19 60, to MAY 2%


19.60


I last saw hl.M.t.alive on


11Hx


28, 1926), death is said to


have occurred on the date stated above, at


730 Am.


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


.62


12


AGE


Years .............. Months ...


.. Days


If under 24 hours


Hours .............. Minutes


13 Usual


Occupation :


Shipper


(Kind of work done during most of working life)


14 Industry


or Business :


Photo Supplies


15 Social Security No.


023 .09 1018


Newton


16 BIRTHPLACE (City)


(State or country)


Mass.


17 NAME OF


FATHER


William R. Coleman


Boston


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Mass.


19 MAIDEN NAME


OF MOTHER


Margaret A. Cannon


20 BIRTHPLACE OF


Co. Mayo


Ireland


21


Richard W. Coleman


89 Hobart Rd. Brighton, Mass.


Informant


(Address)


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


ADDRESS


439 Washingtonft newton


Received and filed


MAY-3-1 1960


19


(Registrar)


PARENTS'


(Signed)


TTO Caplan


A. M. CAPLAN MD


"(PRINT OR TYPE SIGNATURE)


M. D.


(Address) 86PRINCETON ST


Date 5-29


19.60


MOTHER (City)


(State or country)


St. Joseph tanttery


W. Roxbury-


6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


June 2, 1960


19


6 MONTHS


(c)


Due To


CARDIOMEGALY


OTHER


CORONARY ARTERY


CONDITIONS


DISEASE


FYEARS


Was autopsy performed ?


What test confirmed diagnosis ?


INTERVAL


BETWEEN


ONSET AND


DEATH


5 DAYS


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


BRONCHO PNEUMONIA


(b)


Due


CARDIAC DECOMPENSATION


5 DAYS


8 SEX


M


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWED Married


or DIVORCEN


PHYSICIAN - IMPORTANT


[(Was deceased a


U. S. War Veteran,


NO


{if so specify WAR)


[(If death occurred in a hospital or institution,


St: { give its NAME instead of street and number)


Registered No.


Winthrop Community Hospital No.


(Signature of Agent of Board of Health or other)


Aécrit


5/31/10


(Official Designation)


(Date of Issue of Permit)


5 Was disease or injury in any way related to occupation of deceased ?


If so, specify


7 NAME OF


FUNERAL DIRECTOR Martins Curry


10a If married, widowed of divorceBradley


HUSBAND of


(Give maiden name of wife in full)


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.


MAY 311950 ***


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.


R-301A 1


PLACE OF DEATH -


Suffolk


Winthrop (City ir lown) No. 287 Main St.


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.


125


[{If death occurred in a hospital or institution, St Į give its NAME instead "i street and number)


PHYSICIAN - IMPORTANT


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


No


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


a Residence 81 Gladstone St. [ sual place of abode )


St


East . Foston


( li nonresident. give culv 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


May


29.


1960


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


ma y 8.


19


60


to.


,50


death is said to


have occurred on the date stated above, at


11: 30pm.


INTERVAL


BETWEEN


ONSET AND


DEATH 2mos


12


AGE


68


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.


16 BIRTHPLACE (City) (State or country) Italy


17 NAME OF


FATHER


Ferdinado Fatturelli


18 BIRTHPLACE OF


FATHER (City) (State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Giovanina Mardillo


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


21 Informant


Gerald Martino


(Address)


287 Main St. Winthrop


7 NAME OF


FUNERAL DIRECTOR


Frederick J. Nagrath


ADDRESS


East Feston


Received and filed MAY 3-1-1960 19.


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


female


white


10 SINGLE


(write the word)


MARRIED)


WIDOWED Widowe


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Eliseo Martino


(Husband's name in full)


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a)


Cancer of Liver


Due To (b)


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


none


Was autopsy performed?


no


What test confirmed diagnosis ? pathological-surgical


5 Was disease or injury in any way related to occupation of deceased? NO. If so, specify


(Signed)


Clientes


Fetromania, M. D.


Charles .... Liberman


(Address)


(PRINT OR TYPE SIGNATURE) Winthrop, Mass.


5-30-60 Date


6


HolyCross


Malden


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


June 11 19.60


PARENTS


I HEREBY CERTIFY that a satisfactory standard certificate of death was fred with me BEFORE the burial or transit permit was issued: Halble C. pereauxy. (Signature of Agent of Board of Healthor other


healthy Slices 5/3/160 (Official Designation) (Date of Issue of Permit)


TICTIONS OR CERTIFICATE


iving F DEATH


it enter enan one for each ›) and (c)


ds not mean d of dying, art failure, c. It means : or compli- ¡ich caused


ies, if any, De rise to use (a), e under- use last.


dions contrib- ith but not o he terminal co'ition given


apter 137, 1!4. requires anto print or he cause or o death on cates, and , Acts of qres Physi- Int or type d signature.


-6-9-925686


60


May 20


19


I last saw h


e alive on


Hay 29,


11 IF STILLBORN, enter that fact here.


Registered No


2 FULL NAME Alfonsina Martino


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE.


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


..


MAY 311960 /M


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 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.




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