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