Town of Winthrop : Record of Deaths 1961, Part 11

Author: Winthrop (Mass.)
Publication date: 1961
Publisher:
Number of Pages: 542


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 11


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


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., asamended 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 heldrar 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 Fertify 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,11


(3) Medical Examineresinintestyhtelahd certify to all deaths supposably due to injury. These include Hot 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


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. 50


No. Mayflower Nursing Home


Howard Dexter Sprague SPRAGUE, HOWARD


2 FULL NAME


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


9 Surfside Road


Lym, Mass


St.


Lynn Mass


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


(If nonresident, give city or town and State)


Length of stay: In place of death


.. years.


months.


3


days. In place of residence.


7.1 years.


.. .. months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


3 DATE OF


DEATH


March


16


1961


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


Nov


19


....


60, 10.


March 13


1951


That I attended deceased from


I last saw h ... Inalive on


Mid, chy13 19 61, death is said to


8. 4 0.7


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE .. 7.1 ... Years.


.O.Months ....


9 Days


If under 24 hours


Hours ..........


Minutes


13 Usual


Occupation :


Dipper


(Kind of work done during most of working life)


14 Industry


or BusinessGen Elec. Co. River Works


15 Social Security No. 015-09-4147


16 BIRTHPLACE (City)


(State or country)


Mass


17 NAME OF


FATHER


Albert E. Sprague


Albany


18 BIRTHPLACE OF


FATHER (City)


(State or country)


New York


19 MAIDEN NAME


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Maine


Peabody Mass 21 Harold D. Sprague


DATE OF BURIAL


March


18


(City or Town) 1961


7 NAME OF


FUNERAL DIRECTORWilliam C. Goodrich


ADDRESS


128:Washington St Lynns Mass


Received and filed MAR 16-1961 19.


(Registrar)


PARENTS


(Signed)


Arthur H. Bunling


M. D.


OF MOTHER


Carrie Jackson


ArthurH.Bunting


(Address)


(PRINT OR/ TYPE SIGNATURE)


26 (read J / Lynn Date.


3-16061


6


Puritan ..... Lawn


..... Place of Burial or Cremation


Informant


(Address)


9 Surfside Rd, Lynn Mass


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


(Signature of Agent of Board of Health or other)


att


march 16-1961


0


(Date of Issue of Permit)


(Official Designation)


:TIONS R RTIFICATE


ning DEATH enter an one r each and (c)


not mean of dying, rt failure, It means or compli- caused


if any, rise to se


(a), under- last.


se


is contrib- th but not e terminal vion given


ipter 137, requires o print or cause or death on i:ates, and Acts of des Physi- fit or type signature.


+92 5686


Corinari


Due To


Huleric clerosis


(b)


Due


Co Generalized Pi Terioscher


(c)


OTHER


SIGNIFICANT


CONDITIONS


Hnemia


Was autopsy performed?


0 0


What test confirmed diagnosis ?


Physical EX217


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


Suis


10a If married, widowed, or divorced


HUSBAND of


Blanche ...


LAvingston


(Give maiden name of wife in full)


have occurred on the date stated above, at


INTERVAL


BETWEEN


ONSET AND


DEATH


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


Thrombosis


[(If death occurred in a hospital or institution,


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


PHYSICIAN - IMPORTANT


Dexter


f(Was deceased a


U. S. War Veteran,


{if so specify WAR)


No


Divorced


Male


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


R-301A 1


Lynn


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


TO!


1-3


6


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.


MAR 1 61961 PM


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


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


Registered No.


51


S(If death occurred in a hospital or institution, St. ( give its NAME instead of street and number) PHYSICIAN - IMPORTANT


2 FULL NAME


John J. Mccarthy


( First Name)


(Milddle Name)


(Last Name)


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


(a) Residence. No.


(Usual place of abode)


16 Bowdoin Street


St


(1f 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


March 12 ..... 1961.


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


.. Mar.ch ..... 1.6 ...


19 ... 6.1, to ....... Ma.r.ch ..... 1.7.


19.6.1.


1 last saw himlive on


March ...... 1.7 .... , 19 .. 6.1., death is said to


have occurred on the date stated above, at


4:50 PM


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


59


1 dayAGE


.. Years


Months.


Days


If under 24 hours


Hours.


Minutes


13 Usual


Occupation :


Attorney at Law


(Kind of work done during most of working life)


14 Industry


or Business:


Law


15 Social Security No.


16 BIRTHPLACE (City)


Winthrop


(State or country)


Mass


17 NAME OF


FATHER


John McCarthy


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Annie McDade


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


21 Eva McCarthy


Informant


(Address)


16 Bowdoin St., Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate, of death was filed with me BEFORE the burial or transit permit was issued :- Malke & Direanni (Signature of Agent of Board of Health or other)


11000


13/20/6/


(Official Designation)


(Date of Issue of Permity


145


R-301A 1


TIONS I RTIFICATE


'ing DEATH enter n one each and (c)


not mean of dying, rt failure, It means or compli- k caused


if any, rise to ie


(a), under- e


last.


s contrib- sh but not · terminal ion given


lapter 137, 4. requires n to print or e cause or death on cates, and , Acts of res Physi- int or type signature.


6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL March ... 21 19.61.


7 NAME OF


FUNERAL


DIRECTOR


Arthur J. O' Maley


ADDRESS Winthrop .... Mas.s.


Received and filed


MAR 2-0-1961-


.. 19.


(Registrar)


8 SEX


Male


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWER


or DIVORCarried


10a If married, widowed, or diverged


HUSBAND of


Kenney


(Give maiden name of wife in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


A


(a) sub arachnoid hemorrhage


.........


INTERVAL BETWEEN ONSET AND DEATH


Due To


ruptured cerbral aneurism


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed?


.no.


What test confirmed diagnosis?


clinical


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


(Signed)


Charly Palermo( M. D


Charles Salemi MD


(PRINT OR TYPE SIGNATURE)


(Address)


241 Main St


Date


3/17/


1961


Winthrop, Mass.


Winthrop .... Cemetery


Winthrop


PARENTS


f(Was deceased a U. S. War Veteran,


(if so specify WAR)


59


1 day


No. 16 Bowdoin Street


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 hate given bedside care during a last illness from disease un. related to any formof injury 10


(2) Board of Health physiciang 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) WINTHROP (City or Town)


FN'S


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.


52


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


PHYSICIAN - IMPORTANT


2 FULL NAME


(First Name)


(Middle Name) (Last Name)


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


12 SEAFOAM AVE


St.


WINTHROP


(If nonresident, give city or town and State)


Length of stay:


In place of death.


years


months.


8


.days.


In place of residence 3/


years.


months.


.days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


MARCH


19


1961


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


oct


That I attended deceased from


95%, to MARCH 19


19.61


I last saw hi Walive on


March


18, 1961, death is said to


have occurred on the date stated above, at


7:15 Am


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a)


Pneumonia Lefthung


Due To


(b)


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Cardiac Decompensation


6wks. 2 days


Was autopsy performed?


/10


What test confirmed diagnosis?


Clinical


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


(Signed)


Charles


CHARLES LIBERMAN


(PRINT OR TYPE SIGNATURE)


(Address)


WINTHROP, MAS Date 3/19/ 16/


PINEGROVE CEMETERY LYNN, MASI. 6


Place of Burial or Cremation (City or Town) MARCH 21, DATE OF BURIAL 16/


7 NAME OF FUNERAL DIRECTOR frutay C. Haricots


AD R 1642 Commonwealth Ave Boston


Received and filed


MAR 2-0-1961


19.


(Registrar)


PARENTS


18 BIRTHPLACE OF


FATHER (City) (State or country)


GREETE


19 MAIDEN NAME


OF MOTHER


VASILIME GOULOULE


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


GREECE


GEORGE D. KARAGIANNIS


21


Informant


(Address) 12 SEAFIAM RIE WINTAND 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)


HO


march 20-1961


(Official Designation)


(Date of Issue of Permit)


145


₹-301A 1


TIONS


RTIFICATE


ing DEATH enter n one each and (c)


not mean of dying, 't failure, It means or compli- h caused


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


contrib- but not terminal ion given


apter 137, , requires o print or cause or death on cates, and Acts of es Physi- it or type signature.


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


MALE


9 COLOR


WHITE


10 SINGLE


MARRIED


WIDOW PO


or DIVORCEKHIED


(write the word)


10a If married, widows


HUSBAND of


PANAGIOTISA PAPATHANOS


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE 8 Years


Months ....


Days


If under 24 hours


Hours


Minutes


13 Usual


Occupation :


SCORLHELPER


(Kind of work done during most of working life)


14 Industry


or Business :


VARIETY


15 Social Security No.


Harve


16 BIRTHPLACE (City)


(State or country)


GRELLE


SPARTA


No.


MAYFLOWER NURSING HOME DIONISiOS KARAGIANIS


Registered No.


[(Was deceased a U. S. War Veteran,


(if so specify WAR)


110


(a) Residence. No.


(Usual place of abode)


.


Cellulitis Rt. Leg


INTERVAL BETWEEN ONSET ANO DEATH 36hrs


17 NAME OF


FATHER


ANASTASIS KARAGRANIS


diyorced


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.


×


PLACE OF DEATH


Suffolk (County)


PINSE ITT


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.


2 FULL NAME


Rose (Yavitz) Weiner


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


(a) Residence. No. 14 Wave Way Ave


St.


Winthrop


(Usual place of abode)


Length of stay: In place of death.


.......


.... years.


2


.. months ..


days. In place of residence.


30 years.


months


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR


Write


10 SINGLE


(write the word)


Widowed


MARRIED


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Wolf


Weiner


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE 82


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)


Russia


17 NAME OF


FATHER


Samuel Javitz


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Russia


19 MAIDEN NAME


OF MOTHER


CBL


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Russia


6


Golden Crown Lodge


Woburn


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL March 23


7 NAME OF


FUNERAL DIRECTOR


TORF Funeral Service duc


ADDRESS 151 Washington Ave Chelsea


Received and filed MAR 23 1961


.... 19 ..


(Registrar)


PARENTS


Eva B Bould


21


Informant


(Address)


14 Wave Way Winthrop


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


CHONSignature of Agent of Board of Health or other) march 23-1961


(Official Designation)


(Date of Issue of Permit)


UBV


CTIONS )R ERTIFICATE


iving F DEATH : enter han one or each ·) and (c)


i not mean of dying, art failure, c. It means or compli- ich caused


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


ons contrib- ith but not he terminal 'ition given


apter 137, . requires o print or cause or death on cates, and Acts of es Physi- nt or type signature.


19-926662


3 DATE OF


MARCH


22


1961


DEATH


(Year)


(Month)


(Day)


4 I HEREBY CERTIFY,


Sept.


19 50


to ..


March


22


19


That I attended deceased from


61


I last saw h&.Y .. alive on


march 22, 1961, death is said to


have occurred on the date stated above, at


8:15 P.m.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a)


Coronary Occlusion, conte


Due


To Arterios clerotic Heart


Disease


(b)


5 yrs.


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


None


Was autopsy performed?


no


What test confirmed diagnosis ?


Clinical


5 Was disease or injury in any way related to occupation of deceased? No If so, specify Charles Liberman (Signed) M. D. CHARLES LIBERMAN (PRINT QR TYPE SIGNATURE)


(Address)


WINTHROP


Date 3/23/


1961


Registered No.


53


Winthrop Community Hospital No.


[(If death occurred in a hospital or institution,


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


NO


PHYSICIAN - IMPORTANT


[(Was deceased a


U. S. War Veteran,


if so specify WAR)


(If nonresident, give tity or town and State)


INTERVAL


BETWEEN


ONSET AND


DEATH


2 days


R-301A 1


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


1)


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


5


MAR 2 31961 AM


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.


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.


[(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)




Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.