Town of Winthrop : Record of Deaths 1961, Part 15

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 15


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).


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CICUTE CORONARY OCCLUSION


(a)


....


Due To ARTERIO -SCLEROTIC HEART (b)


SYRS


DIS


Due To


GENERAL ARTERIOSCLEROSIS


5YRS


OTHER


SIGNIFICANT


CONDITIONS


DIABETES MELLITUS


10YRS


Was autopsy performed?


10


What test confirmed diagnosis ?


CLINICAL


5 Was disease or injury in any way related to occupation of deceased 10 If so, specify


(Signed) Import King M. D. MYRONUN KING MOD


(PRINT OR TYPE SIGNATURE) LLL PLEASANT ST


4/18 /06/


(Address) WIZYTATODate .... Winthrop, Mass,


6


Winthrop Cemetery


(City or Town)


April 20 1961


7 NAME OF FUNERAL DIRECTOR ADDRESS 174 Winthrop 'St. Winthrop


Received and filed


19


(Registrar)


PARENTS


Registered No. 69


[(If death occurred in a hospital or institution,


PHYSICIAN - IMPORTANT


{(Was deceased a


U. S. War Veteran,


[if so specify WAR)


NO.


TRUCTIONS FOR AL CERTIFICATE


n giving E OF DEATH not enter "e than one se for each , (b) and (c)


does not mean ode of dying, heart failure, , etc. It means ase, or compli- which caused


tions, if any, gave rise to cause (a). the under- cause last.


ditions contrib- death but not to the terminal condition given


Chapter 137, 1954, requires ans to print or he cause or of death on ertificates, and 48, Acts of quires Physi- print or type der signature.


1.6.


0.6-59-925686


M R-301A 1


MEDICAL CERTIFICATE OF DEATH


INTERVAL


BETWEEN


ONSET AND


DEATH


15 MIN


Hours ............


(c)


Chester


Place of Burial or Cremation DATE OF BURIAL


alfred B. March


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE.


DATE OF DISCHARGE ACCEIVED: RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


5


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 Rectify 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 fecognized 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 freeded.


(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 hy 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


Middlesex (County)


Cambridge


(City or Town)


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


Cambridge


(City or Town making this return)


563 70


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


2 FULL NAME


Anna Brandow


(Gibson)


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


10 Revere St.


St.


winthrop,


Mass.


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


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


April 17, 1961


( Month)


(Day)


(Year)


8 SEX


F


9 COLOR


white


10 SINGLE


( write the word)


MARRIED


WIDOWED


or DIVORCED


widowed


4 I HEREBY CERTIFY.


That I attended deceased from


April 11,


19.


61


April 17,


61


19


19


Of death is said to


have occurred on the date stated above, at


.m.


INTERVAL BETWEEN ONSET ANO DEATH


(or) WIFE of.


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


7 lays


12


.87


0


Months.


29


If under 24 hours


Hours.


Minutes


Due Tolassive Cerebrovascular (b)


Accident


6 wks.


13 Usual


Occupation :


( Kind of work done during most of working life)


14 Industry


or Business :


Hono


15 Social Security No.


Kartnicht


16 BIRTHPLACE (City)


(State or country)


17 NAME OF


FATHER


James T. Gibson


18 BIRTHPLACE OF


Cannot be learned


FATHER (City)


New York


(State or country )


19 MAIDEN NAME


OF MOTHER


Margaret Stranaghan


20 BIRTHPLACE OF


Cannot be learned


MOTHER (City) ....... Jew ..... York ...


(State or country )


walter Johnson


Informant 1.0 .... Rovore .... St ...... /inthrop ( Address )


7 NAME OF


Howard S. Reynolds


FUNERAL DIRECTOR


ADDRESS winthrop, Mass:


Received and filed 5-3-61 19


( Registrar of City or Town where deceased resided)


PARENTS


Francis E. Smith


(Signed )


85 Otis St.Camb


Apr. 18


M.


67


( Address )


Date ...


woodlawn Crematory Everett


Place of Burial or Cremation


April 22,


61


[City or Town)


21


DATE OF BURIAL


19


A TRUE COPY Frederick H Burke


ATTEST :


( Registrar of City or Town where death occurred)


DATE FILED


April 20,


.19


67


6 Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c) 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


FORM R-302


WRITE PLAINLY, WITH UNFADING BLACK INK OR USE APPROVED BLACK TYPEWRITER RIBBON - THIS IS A PERMANENT RECORD


.


50M-9-59-926111


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed ?


Exam


What test confirmed diagnosis ?


HO


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


AGE


Years


Days


Housewife


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


John A. Brandow


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Bronchopneumonia, Terminal


(a)


to ...


I last saw h.


efive on


April 17


.....


11:50P


( If nonresident, give city or town and State)


30


( Was deceased a


U. S. War Veteran.


(if so specify WAR


Registered No.


Guardian Hospital No


1


At Home


CLERK


IN


L'28


NIW


THROP MASS.


31961 AM


5


WIN


MAY:


OFFIC


*


SPACE FOR ADDITIONAL INFORMATION


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


PLACE OF DEATH


Suffolk (County)


CENSE PETTO


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.


71


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


Curley


PHYSICIAN - IMPORTANT


2 FULL NAME


Michael .... J ........ Kirley.


(First Name)


(Middle Name)


(Last Name)


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


14 Waldemar Ave.


St


(If nonresident, give city or town and State)


.. months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


April ..... 201961


(Month)


(Day)


(Year)


4 I HEREBY


CERTIFY


That I attended deceased from


1/27


55


APRIL 20


19


61


to ...


I last saw h././?lalive on


APRIL 19 1961


death is said to


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


74


AGE


Years.


Months.


.Days


If under 24 hours


Hours.


......


Minutes


13 Usual


Occupation :


Retired ..... Machinist


(Kind of work done during most of working life)


14 Industry


or Business :


Shipbuilding


15 Social Security No.


011-05-9475


16 BIRTHPLACE (City)


(State or country)


Ireland


17 NAME OF


FATHER


James Kirley


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Maria C. Murray


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


21 Agnes Murphy


Informant


(Address)


14 Waldemar Ave., Winthrop


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


(Signature of Agent of Board of Health or other)


40


april 21-1961.


(Official Designation)


(Date of Issue of Permit)


VD


6J-928145


M R-301A 1


TRUCTIONS FOR L CERTIFICATE


1 giving OF DEATH


not enter e than one e for each (b) and (c)


does not mean de of dying, heart failure, etc. It means se, or compli- which caused


ions, if any, gave rise to cause (a), the under- cause last.


-


Due To


(b)


CARCINOMA CE STOMACH


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


None.


Was autopsy performed?


What test confirmed diagnosis? CHERATION


ATV.A. Hesp


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


(Signed)


Ingrown Truy


.... , M. D


MYRON ON. KING MD


(PRINT OR TYPE SIGNATURE)


(Addre LIL PLEASANT ST . Date. 4/21 196/


6 Holy ..... Cross Cem .. Malden


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


April 24 .1961


7 NAME OF


FUNERAL DIRECTOR


Arthur J. O' Maley


ADDRESS Winthrop Mass


Received and filed APR 24 1981 19


( Registrar)


8 SEX


Male


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIEROBBIE


10a If married, widowed, or divorced


HUSBAND of


have occurred on the date stated above, at


1095P


.m.


INTERVAL


BETWEEN


ONSET AND


DEATH


Emo.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


....


GENERAL CARCIAG MATOSIS


8140


PARENTS


Registered No.


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


[if so specify WAR) ww#1


(a) Residence. No.


(Usual place of abode)


Length of stay: In place of death ..


years ...


months ...........


.days. In place of residence.3.5 .... years


No. 14 Waldemar Ave


:- Chapter 137, 1954. requires ians to print or the cause or of death on certificates, and pr 48, Acts of equires Physi- o print or type ender signature. C.


litions contrib- death but not o the terminal ondition given


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


1-2-18


DATE OF DISCHARGE


9-30-2-1.


RANK, RATING


A.M.M Ist Cl


ORGANIZATION AND OUTFIT


U.S.Navy


SERVICE NUMBER 1235160


RULES OF PRACTICE


RECEIVED


OF TOWA


11 12 1


in


5


LF 2450


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-303 A 1


N. B .- 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 piain terms, so that it may be properly classified under the International Classification of Causes information should be carefuliy 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 recitai to that effect.


SOM-6-60-928145


PLACE OF DEATH


SUFFOLK


(County) WINTHROP (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.


22


4 Elmwood Court, Winthrop No.


(If death occurred in a hospital or institution,


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


PHYSICIAN - IMPORTANT


(First Name)


(Middle Name)


(Last Name)


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


4 Elmwood Court, Winthrop


(a) Residence. No.


(Usual place of abode)


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


April


20,


1961


9 SEX


10 COLOR


11 SINGLE


(write the word)


Female


White


MARRIED


WIDOWED


or DIVORCEISingle


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.) PNEUMONITiS


11a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


12 IF STILLBORN, enter that fact here.


13


2


AGE


Years ....


......


Months.


Days


Hours


.Minutes


14 Usual


Occupation :


(Kind of work done during most of working life)


15 Industry


or Business :


16 Social Security No.


Winthrop


17 BIRTHPLACE (City)


(State or country)


M888


18 NAME OF


FATHER


James F Margotta


19 BIRTHPLACE OF


Stamford


FATHER (City)


(State or country)


Conn.


20 MAIDEN NAME


OF MOTHER Sheila Haraden


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Me.


Portland


22 James F Margotta


Informant


(Address)


4 Elmwood CC, Winthrop


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 oy other)


4/20/61


(Official Designation)


(Date of Issue of Permit) X


Received and filed 19


PARENTS


(Signed)


Leonard Atkins, M.D.


Boston (Print or Type Signature) 4/20 61


19


7 Winthrop


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


DATE OF BURIAL April 21 19 .. 61


8 NAME OF


Ernest P Caggiano


ADDRESS


147 Winthrop St, Winthrop


Date


winthrop


(Address)


Leonard Ochin


M. D.


Injury


(How did injury occur?)


Nature of


Injury


While at work?


Was autopsy performed ?


NO


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


(Specify type of place)


Manner of


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 ?


If under 24 hours


5 Accident, suicide, or homicide (specify)


Date and hour of injury


19


(Month)


(Day)


(Year)


[(Was deceased a


U. S. War Veteran,


(if so specify WAR)


St.


(If nonresident, give city or town and State)


2 FULL NAME


CAROL ANN MARGOTTA


§§ 44-48.


VED SPACE FOR ADDITIONAL INFORMATION


OW", DATE OF ENTERING MILITARY SERVICE


21


DATE OF DISCHARGE


3)


e


RANK, RATING


0 ORGANIZATION AND OUTFIT


SERVICE NUMBER


1 1901 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 unrelated to any form of injury.


(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or 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."


If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"


RM R-304


tal or maternal dition causing al death (do t use such ms as stillbirth ( prematurity. ) Ital and/or ma- tnal conditions, fany, which gave rse to above cise (a), stating te underlying case last.


Unditions of fetus 0 mother which By have contrib- ed to fetal 'th, but, in so as is known, we not related Acause given (a).


15M-6-60-928241


PLACE OF DELIVERY No.


2 NAME OF FETUS (if given


Suffolk (County ) Winthrop (City or Town Wintrop Community Vos petal Baby Boy Gillis


The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS CERTIFICATE OF FETAL DEATH ( STILLBIRTH)


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


Registered No.


73


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


3 DATE OF


DELIVERY


april 29, 1961


Minth


{ Day


(Year


7 IF MULTIPLE BIRTH, BORN :


1st.


.2nd


3rd


4 SEX


Male // .. Female ... Undetermined


5 COLOR (if


determined W/


6 THIS BIRTH (Check one)


Single / Twin


Triplet


MOTHER


Rose Valletta


8


FULL ·


NAME


Walter Gillis


PRESENT NAME


Kose Gillis


RESIDENCE,


129 Cottage St.


STREET


CITY OR TOWEast Boston


STATEass.


10 COLOR OR


RACE


W


11 AGE AT TIME OF


THIS DELIVERY


4.3 (Years)


16 COLOR OR


RACE


W


17 AGE AT TIME OF


THIS DELIVERY


33 (Years)


12 PLACE OF


BIRTH


Winthrop, Mass.


(City or Town


State or country


Packer


13 OCCUPATION


20 PREVIOUS DELIVERIES TO MOTHER


(Do not include this fetus)


3


(a) How many children are


now living ?


(b How many children were born alive but are now dead ?


(c) How many previous fetal deaths of ANY gestation age?


24 AUTOPSY


Yes


No L


21 LENGTH OF


PREGNANCY


35 completed


weeks


25 FETAL DEATH WAS CAUSED BY: IMMEDIATE CAUSE Unknocon (a)


?- Diabetes


Due To (b) +Due To (c)


OTHER SIGNIFICANT


CONDITIONS


Mascarated Fetus


26


Holy Cross Cemetery


Malden


Place of Burial or Cremation


DATE OF BURIAL


May 2,


(City or Town) 1961


27 NAME OF FUNERAL DIRECTOR


Vincent Kapino


9 Chelsea St., East Boston, Mass.


ADDRESS


Received and filed MAY 2 1961 19


Registrar


I HEREBY CERTIFY that this delivery occurred on the date stated & Yum . and product of conception was not a live birth.


above at


Signature of Attending Physician or Medical Examiner:


M.D


Louis E Schraffa (PRINT OR TYPE SIGNATURE) 15 Benning Te MIT Elagente


DateChuck 2, 1961


I HEREBY CERTIFY that a satisfactory certificate of fetal deat was filed with me BEFORE the burial or transit permit was issued


Signature' of Agent of Board of Health or other )


May 2/196


HO


(Date of Issue of Permit)


Official Designation


1


In giving CAUSE OF ETAL DEATH


STREET


Masso


18 PLACE O


BIRTH


(City or Town


Boston, Massachusetts


(att or country )


Walter Gillis (father)


19 INFORMANT


2


23 WHEN DID FETUS DIE?


During Labor


or De ivery


Before


Labor


Unknown


Grams


(or


FATHER


14


MAIDEN NAME


15


RESIDENCE, NO.


CITY OR TOWN


129 Cottage East Boston


do not enter more than one cause for each of (a), (b) and (c)


22 WEIGHT OF FETUS


Lb.


Oz


St.


TON


FETAL DEATH


1 ...


7


6


EXTRACTS OF CERTAIN SECTIONS OF CHAPTER 46 AS AMENDED OR ADDED BY CHAPTER 48. ACTS OF 1960.


MAY =21961 AM


Section 2A. "Examination of records and returns of illegitimate births, or abnormal sex births, or fetal deaths, . . . shall not be permitted except ... "


Section 9A. When a child is born dead, after a period of gestation of not less than twenty weeks, and in the fetus there is no attempt at respiration, no action of heart and no movement of voluntary muscle, the physician or officer attending at the birth of such child shall forthwith furnish for registration, at the request of an undertaker or other authorized person or of any member of the family of the deceased, a certificate of fetal death on a form which shall be prepared by the secretary of state as required by section sixteen. Town clerks shall record certificates of fetal death in the town register of deaths in the same manner as a death certificate, but they shall not be required to record such certificates in the town register of births.


Section 12. " ... No birth record of a child born out of wedlock or of a child of abnormal sex, and no record of fetal death shall so be transmitted to any other city or town."


Section 24. In any statement of births, deaths and fetal deaths printed by a town the name of an illegitimate child or of its parents or of the parents of a child born dead shall not be printed, but the word "illegitimate" or "fetal death" shall be used in place thereof. A town violating this section shall forfeit to the mother of such child not more than one hundred dollars.


PLACE OF DEATH


Suffolk (County) Winthrop, Mass. (City or Town)


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


STANDARD


CERTIFICATE OF DEATH


Registered No.


74


2 FULL NAME McGuirk, Twin Girl #1 (If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence. No.


8 Constitution Ave. Revere, Mass. (Usual place of abode)


(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


3 DATE OF


DEATH


April


(Month)


26.1961


(Day)


(Year)


4 I HEREBY CERTIFY


That I attended deceased from


4/26/


19


64 0 4/26/61


19


I last saw h


4/26


death is said to


have occurred on the date stated above, at


3.25 pm.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a)


Prematurity


Due To


Primature labor-


(b)


Due To


Placenta Previa marginal


(c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


What test confirmed diagnosis ?


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


(Signed)


a Paul Dur Hagopian


M. D.


A. Paul DERHAGO PIAN PRINT OR TYPE SIGNATURE), (Address) 34 CARYA/CHELSEA Date av.26


Winthrop Cemetery Winthrop 6


(City or Town)


Place of Burial or Cremation


DATE OF BURIAL


April 28,


19.61


7 NAME OF FUNERAL DIRECTOR Frederick J. Magrath


ADDRESS 45 al App 28° 1961 E.Boston


Received and filed 19


(Registrar)


8 SEX Female


9 COLOR


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word


Singl


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.


12


AGE ..


.. Years ............


Months.


Days


1 funder 24 hour


Hours ..


Minutes


13 Usual


Occupation :


(Kind of work done during most of working life)




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