USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1960 > Part 41
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have occurred on the date stated above, at
12:35Pm.
INTERVAL
BETWEEN
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
ONSET AND
DEATH
luk
Cerebral Hemorrhage
(a)
(b)
Hypertension and
Arteriosclerosis
That I attended deceased from
Mayflower Nursing Home
No. .
1-10-60
M R-301A 1
(Signed)
Charles Liberman
238(PENDERETYPE SIGNATURE)
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.
RM R-302
1
PLACE OF DEATH
Suffolk
(County)
Revere
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Revere
(City or Town making this return)
1.88
Grover Manor Hospital No
Albert G. Strachan, Jr.
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
125 Grovers Ave.
X
Winthrop
(a) Residence. No. ( Usual place of abode)
3
(If nonresident, give city or town and State)
Length of stay: In place of death .......... years .......... months ... 1 days. In place of residence years .. .... months .......... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
August
14,
1960
( Month)
(Day)
( Year)
8 SEX
Male
9 COLOR
White
10 SINGLE
( write the word )
MARRIED
Married
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY,
Feb.
19 60
That I attended deceased from 60
Aug.
60
19
10a If married, widowed A divorced HUSBAND of
Ferrari
( Give maiden name of wife in full)
have occurred on the date stated above, at
INTERVAL BETWEEN DNSET AND DEATH
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
minutes2
54
3
18
AGE
Years.
.Months
.Days
If under 24 hours
Hours ........ Minutes
1 week
13 Usual
Occupation :
Foreman
(Kind of work done during most of working life)
14 Industry
or Business :
Boston Paper Board
15 Social Security No.
022-10-2912
Everett
Mass.
17 NAME OF FATHER Albert G. Strachan
18 BIRTHPLACE OF
Halifax
FATHER (City)
(State or country )
Nova Scotia
5 Was disease or injury in any way related to occupation of deceased ? N.O. If so, specify
(Signed )
Edward A. Fiorentino
M. D.
(Address )
Everett
Date.
8/15
60
19
Glenwood Cemetery
Everett
6
18y or Town)
60
Place of Burial or CremationAugust
DATE OF BURIAL
.19
21
Informant
( Address)
125 Grovers Ave. , Winthrop
7 NAME OF
FUNERAL
J. E. Henderson Co.
DIRECTOR
517 Broadway, Everett
ADDRESS
Received and filed SEP 2 1960 19
(Registrar of City or Town where deceased resided )
PARENTS
19 MAIDEN NAME
OF MOTHER
Annie Edgar
London
20 BIRTHPLACE OF
MOTHER (City)
England-
(State or country)
Mrs. Rena A. Strachan
A TRUE COPY
ATTEST :
(Registrar of City or Town where death occurred )
DATE FILED
August
16,
60
19
×
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
5
?
50M-9-59-926111
resided as soon as possible, after the close of the month in which the death occurred. (See 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
Due To Coronary Insufficiency
(b)
Due To Coronary artery disease (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed ?
no
What test confirmed diagnosis ?
EXG.
2 years
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Coronary Occlusion
(a)
10:05₽
19. death is said to
I last saw Illive on Aug. 14,
( Was deceased a
U. S. War Veteran,
if so specify WAR,.
S (If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
(City or Town)
Registered No.
.66 Broadway
16 BIRTHPLACE (City)
(State or country)
E
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING SEP -21960 /1 ORGANIZATION AND OUTFIT SERVICE NUMBER
X
PLACE OF DEATH
Suffolk (County)
CENSE PF TIT
Winthrop (City or Town)
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.
Registered No. 189
[(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)
229 Washington Ave ..
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .............. years.
months.
1.3 .. days. In place of residence ...
40
.. years.
........ months ..
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Aug.
19
1960
(Month)
(Day)
(Year)
Female
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
or Diodowed
(write the word)
4 I HEREBY
CERTIFY,
That I attended deceased from
July 6
100, to Alle
19
19.
60
60
..... L.
death is said to
have occurred on the date stated above, at
10:20 PM
(or) WIFE of
(Give maiden name of wife in full)
David J. Gaddis
(Husband's name in full)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Generalized Carcinomatosis
INTERVAL
BETWEEN
ONSET AND
DEATH
1 mo
66
12
AGE.
Years
.. Months.
Days
Hours ...........
.Minutes
13 Usual
Occupation :
Dispatcher
(Kind of work done during most of working life)
14 Industry
Taxi
o or Business :
15 Social Security No.
032-03-3845
Boston
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
Roger Mansfield
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
., M. D.
OF MOTHER
Mary Brian
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21
Joan Gaddis
Informant
(Address)
229 Washington Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit- was issued: Maliye . perrammet
(Signature of Agent of Board of Health or other) Health Aride 8 22 /60
(Official Designation) UV
(Date of Issue of Permit)
V.I.S.V
UCTIONS FOR CERTIFICATE
giving OF DEATH
ot enter than one for each b) and (c)
es not mean of dying, heart failure, tc. It means , or compli- hich caused
ns, if any, ave rise to cause (a), the under- ause last.
ions contrib- eath but not the terminal dition given
Chapter 137, 54. requires s to print or cause or death on ificates, and 48, Acts of ires Physi- rint or type r signature.
Winthrop Cemetery . Winthrop
Place of Burial or Cremation
August 23
(City or Town)
19
60
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS Winthrop ........ Mass
Received and filed AUG 2.3 1960 19
(Registrar)
3-4
Due To
(c)
OTHER
SIGNIFICANT
None
CONDITIONS
Was autopsy performed?
No
What test confirmed diagnosis? Clinical & Lab./
5 Was disease or injury in any way related to occupation of deceased ?I.O ...
If so, specify).
M. Fraumetri K
(Signed)
T.T. Traunstein .... M.D.
(PRINT OR TYPE SIGNATURE)
(Address)
73 Bartlett Rd.
8/19/60 19
6
DATE OF BURIAL
PARENTS
10a If married, widowed, or divorced
HUSBAND of
11 IF STILLBORN, enter that fact here.
If under 24 hours
Due To
Carcinoma of Liver
(b) ....
R-301A 1
No.
Winthrop Community Hospital
2 FULL NAME
Margaret( Mansfield) Gaddis
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
8 SEX
I last saw h .. Salive on
Aug.
19
59-925686
15,
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.
-
AUG 2 31300
X
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
2 FULL NAME
Mary S. Austin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
(Usual place of abode)
Length of stay: In place of death.
18years ...
.. months. .......... .days. In place of residence .. 1.8 .. years .............. months. ............. days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEnidowed
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Harry O. Austin
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
76 Years.
.11.Months
26
„Days
If under 24 hours
Hours ..........
.. Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
Own Home
15 Social Security No.
None
Everett
16 BIRTHPLACE (City)
(State or country)
Massachusetts
17 NAME OF
FATHER
Thomas C. Stephenson
18 BIRTHPLACE OF
Cannot be learned
FATHER (City)
(State or country)
England
19 MAIDEN NAME
OF MOTHER
Agnes Haynes
20 BIRTHPLACE OF
MOTHER (City)
....
Cannot be learned
(State or country)
England
21 Informant (Address)
Byr1 Magoon
241 Court Rd. Finthron Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
1
(Signature of Agent of Board of Health or other)/
8/26/60
(Registrar)
PARENTS
(Signed).
Cluster
Lebensraum. D.
CHARLES LIBERMAN
(PRINT OR TYPE SIGNATURE)
(Address) BEARD OFHEALTH Date.
8/20
1966
6
Mt. Pleasant Cemetery, Arlington
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
August
23.150
7 NAME OF
FUNERAL DIRECTOR
Saville, Inc.
ADDRESS Arlington, Mass,
Received and filed AUG 22-1960
19
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.
190
[(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
f(Was deceased a
U. S. War Veteran,
(if so specify WAR)
no
St. (If nonresident, give city or town and State)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
August
20
1960
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
19
19
........ , to
I last saw h ........ alive on
1
19
death is said to
have occurred on the date stated above, at
2:00A. m.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Presumably due to
INTERVAL BETWEEN ONSET AND DEATH
Due
natural causes, arterio
(b)
sclerosis and arterio -
Selerotic heart disease ..
(c)
Winthrop Boardof Health
OTHER
SIGNIFICANT
CONDITIONS
Charles Liberty Min
Was autopsy performed ?
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify
..........
R-301A 1
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
es not mean e of dying, heart failure, etc. It means e, or compli- which caused
s, if any, gave rise to cause (a), the under- cause last.
tions contrib- death but not the terminal dition given
Chapter 137, 954. requires is to print or cause or f death on tificates, and 48, Acts of uires Physi- print or type er signature.
1
-59-925686
(Official Designation) (
(Date of Issue of Permit)
Registered No.
241 Court Road
(Stephenson)
241 Court Road
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE.
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
AUG 2 21960 /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 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.
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
No.
135 Main St.
The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
191
§(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
135 Main St.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .... .. .. years .months . .. days. In place of residence. 53
.years
months
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August 22 1960
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
That I attended deceased from
Dec 3
1959, to august 22
60
I last saw HO .. alive on
August 151960, death is said to
have occurred on the date stated above, at
4:00 Am.
INTERVAL
BETWEEN
ONSET ANO
DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) uremia
Due To
arteriosclerosis- senility
(b)
.....
3 mos
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Congestive heart failure
byrs.
Was autopsy performed?
No
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased ? No If so, specify
(Signed) H.BANenfield H.B. Green field 447 Shirley St
(PRINT OR TYPE SIGNATURE)
Winthrop Mass Date Oug +2 .19 60
6 Old Calvary Cemetery
Boston
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
August 24
19 60
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
Winthrop Mass
ADDRESS
Received and filed AUG 2.3 1960 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WH
10a If married, widowed, or divorced
HUSBAND of
Charles D. Ginepra
Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
94
AGE.
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 :
Own Home
15 Social Security No.
Boston
16 BIRTHPLACE (City)
(State or country)
Ma88
17 NAME OF
FATHER
Vanni
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
19 MAIDEN NAME
M. D. OF MOTHER Louise Gazzola
20 BIRTHPLACE OF MOTHER (City) (State or country)
Italy
21 Informant (Address)
Ruth Ginepra 135 Main St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
vialele Jerean D (Signature of Agent of Board of Health/ or other)
8/23/60
H(Official Designation)
(Date of Issue of Permit) , 4.1
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
oes not mean e of dying, heart failure, etc. It means se, or compli- which caused
ons, if any, gave rise to cause (a), the under- cause last.
itions contrib- death but not the terminal ondition given
Chapter 137, 954. requires is to print or : cause or of death on tificates, and 48, Acts of uires Physi- print or type er signature.
1-59-925686
Lida E. Ginepra
Vanni
[(Was deceased a
U. S. War Veteran,
lif so specify WAR)
(a) Residence. No. ( L'sual place of abode)
To be filed for burial permit with Board of Health or its Agent.
R-301A -
PARENTS
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 les of practice : AUG 1960 TM
(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.
R-301A 1
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 e, or compli- which caused
ns, if any, ave rise to cause (a), the under- cause last.
tions contrib- leath but not the terminal ndition given
Chapter 137, 154, requires s to print or cause
or f death on ificates, and 48, Acts of uires Physi- rint or type er signature.
59-925686
PLACE OF DEATH
Suffolk (County)
CONSE
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.
192
[(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Margaret A. Mahoney
Riley
(If deceased is a married, widowed or divorced woman, give also maiden name.)
90 Lowell Road
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 CERTIFICATI OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
or mdowed
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
William H. Mahoney
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
90
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 :
Own Home
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
England
17 NAME OF
FATHER
John P. Riley
18 BIRTHPLACE OF
FATHER (City)
(State or country)
England
19 MAIDEN NAME
M. D. OF MOTHER Elizabeth Joyce
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
6 Holy Cross Cemetery Malden Mass21
(City or Town)
Place of Burial or Cremation DATE OF BURIAL
August 24
19
60
(Address)
Informant Lillian Mahoney "Lowell Road' Winthrop
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
Winthrop Mass
Received and filed
AUG 23 1960
19
(Registrar)
6 mos.
Due To (c)
OTHER SIGNIFICANT Cerebral thrombosis (old) COND Congestive heart failure
Was autopsy performed?
No
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased?No. If so, specify
(Signed)
H.Bbienfield H.B. Greenfield
147 Shirley St
(PRINT OR TYPE SIGNATURE)
(Address) W. anthrop Date. Mass 19. 10
PARENTS
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued:
(Signature of Ageor of Board of Health or other)
Header Gliche
8/23/6
(Official Designation)
(Date of Issue of Permit)
(write the word)
3 DATE OF
DEATH
August 22 1960
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
٦ ٧٧٥٧
1952
to ....
august 24 22
19.60
That I attended deceased from
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