USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 2
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(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 1961 PM (drugs or poisons) thermal, or electrical agents, and deaths following &run but also deaths from disease resulting from injury or infection relat d'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)
17-100
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD
CERTIFICATE OF DEATH Mayflower Beat Home 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)
Briton mars
(If nonresident, give city or town and State)
Length of stay: In place of death .. ............ years ............. months. ............ days. In place of residence .............. years.
months. .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Jan.8 1961.
(Day)
(Year)
That I attended deceased from
61
I last saw h.M alive on JAN 8
61
19. death is said to
have occurred on the date stated above, at
9 20 PM.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
CEREBRAL HEMORRHAGE
(a)
Due To GENERALIZED ARTERIO- (b)
SCLEROSIS
Due To (c)
OTHER SIGNIFICANT DIABETES CONDITIONS
3YRS
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
Doyl Hacima M. D.
(Signed) JOSEPHO J. PALERMO
(PRINT OR TYPE SIGNATURE)
(Address) Revere. Mars DaNAN 10 1961 It. Miguel Cemetery
6
Place of Burial or Cremation DATE OF BURIAL
19.6.1
7 NAME OF
ADDRESS
Received and filed JAN 10-1961
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR Haute
10 SINGLE MARRIED WIDOWER or DIVORCED
(write the word) Matrah
10a If married, widowed, or divorced HUSBAND of ...
angelina Di Rienzo (Give maiden name of wife in fu d)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 70 Years
Months ...........
Days
If under 24 hours
Hours.
.Minutes
13 Usual
Occupation :
Retired
(Kurd of work done during most of working life)
14 Industry
or Business :
Self Employed.
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Italy
17 NAME OF
FATHER
Giovanni Colabelli
18 BIRTHPLACE OF
Italy
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Unlavoron
Italy
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Reta Inteso
21 Informant (Address)
Mintharper, Mel
I HEREBY CERTIFY that a satisfactory standard certificate of death as filed with ple BEFORE the burial or transit permit was issued; Ralph 5
(Signature of Agentsof Board of Health or other)
HOU
Jan 10/6/
(Official Designation)
(Date of Issue of Permit)
X
ISTRUCTIONS FOR :AL CERTIFICATE
In giving E OF DEATH o not enter re than one use for each .), (b) and (c)
does not mean sode of dying, is heart failure, a, etc. It means rease, or compli- which caused
litions, if any, h gave rise to e cause (a), ng the under- cause last.
nditions contrib- o death but not to the terminal condition given
:- Chapter 137, f 1954. requires ians to print or the cause or of death on certificates, and fer 48, Acts of requires Physi- to print or type inder signature.
146-59-925686
RM R-301A 1
2 FULL NAME
Frank Colabelli
(If deceased is a married, widowed or divorced woman, give also maiden name.) 224 Hanovel ....... St.
(a) Residence. No. (Usual place of abode)
(Month)
4 I HEREBY CERTIFY, NOV 5 19 5% to VAN 8
19 ..
INTERVAL BETWEEN ONSET AND DEATH 5 DAYS
10 YRS
PARENTS
19.
To be filed for burial permit with Board of Health or its Agent.
Registered No. 6
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RECE YED
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE
0
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 illa 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. 1
(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.
JAN 1 01961 PM
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 i( ounty )
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.
[(If death occurred in a hospital or institution,
St. ? give its NAME instead of street and number)
2 FULL NAME ..
James L. Butler
(If deceased is a married, widowed or divorced woman, give also maiden name.)
143 Revere Street, Winthrop
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ..
2
years
months
days. In place of residence.
2.years.
months ..
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDMarried
4 I HEREVY CERTIFY, That
511
, 19.62 .. , to
119
attended deceased from
I last saw h ....... alive on
119
1961
.... ,
death is said to
have occurred on the date stated above, at
8.15Pm.
INTERVAL BETWEEN ONSET AND DEATH
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12 AGE 50 .. Years ... 9. Months.2.9 .. .Days
If under 24 hours
Hours .............. Minutes
13 Usual
Occupation :
Yard .... man
(Kind of work done during most of working life)
14 Industry
or Business :
Oil ... Co.
15 Social Security No. .
028-03-2420
16 BIRTHPLACE (City) (State or country) Mass.
Everett
17 NAME OF
FATHER
Richard Butler
18 BIRTHPLACE OF
FATHER (City)
(State or country)
P.E.I.
19 MAIDEN NAME
OF MOTHER
Annie Johnston
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
PE.I.
21 Mrs. Theresa M. Butler-wife
Informant
(Address 1 43 Revere St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE, the burial or transit permit was issued: TackLE Serianni
(Signature of Agent of Board of Health or other)
HO
1/ 12/6/
(Official Designation)
(Date of Issue of Permit)
STRUCTIONS FOR AL CERTIFICATE
n giving E OF DEATH
not enter re 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), g the under- cause last.
iditions 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 r 48, Acts of equires Physi- › print or type nder signature.
2.1.6
7 NAME OF FUNERAL DIRECTORIchard C. Kirby, Inc. ADDRES.917 Bennington St. , E. Boston.
Received and filed JAN 1% 105 19
(Registrar)
PARENTS
Fred d' Regan FRIED O'REIGAN AND
(Signed) M. D.
AWEERTHROL 113PLEASANT Date 1/12
(Address)
........... SCLEROSIS
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed ?
0
What test confirmed diagnosis ?
19
10a If married, widewed, or divorced
HUSBAND of
Theresa M. Ruggiero
(Give maiden name of wife in full)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
CORONARY OCCLUSION
(a)
Due To CORONARY
(b)
Jan
11
1961
3 DATE OF
DEATH
(Month)
(Day)
(Year)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran lif so specify WARCBL
(a) Residence. No. ( U'sual place of abode)
No. Onsidewalk ... at 143 Revere Street
M R-301A 1
[-6-59-925686
5 Was disease or injury in any way related to occupation of deceased ? O If so, specify
Holy Cross Cemetery, Malden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
January
14th
61
Medical &jamas Informmay my 1 /11/6,
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
: 1
2
63
THROT
JAN 1 21961 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.
·
IM R-301A 1
STRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH
› not enter re than one ise for each ), (b) and (c)
does not mean ode of dying, s heart failure, , etc. It means ease, or compli- which caused
itions, if any,
gave rise to
cause (a),
ig the under-
cause last.
-
arteriosclerosis -
Due To
generalized
(c)
Senility
OTHER
Fracture of Humerus-SV,
CONDITIONS
2 cases
16 BIRTHPLACE (City)
(State or country)
Nova Scotia
17 NAME OF
FATHER
Dougal Mackinnon
18 BIRTHPLACE OF
FATHER (City)
Cape Breton
(Signed)
Joseple Aregone
M. D.
(State or country)
Nova Scotia
JOSEPH GREGORIE
(PRINT OR TYPE SIGNATURE)
(Address)
194 Washugh Date.
1/11
61
Winthrop Cemetery
6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
January 13
19
61
7 NAME OF
FUNERAL DIRECTOR
Arthur J O'Maley
ADDRESS
Winthrop Mass
Received and filed
JAN 1 6 130
19
(Registrar)
-60-928145
PLACE OF DEATH
Suffolk (County)
ENSE PETIT
Winthrop
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
S(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Florence
Mackinnon
(First Name)
(Middle Name)
(Last Name)
{if so specify WAR)
(1f deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
556 Shirley Street
.....
St.
(1f nonresident, give city or town and State)
Length of stay: In place of death ...
.years .......... months .........
.days. In place of residence.50 ... years ..
.. months ..
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
January 11 1961
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
19 60, to Jan. 11
19.4
...
....... ..
I last saw heralive on
Jan 10
1968
death is said to
have occurred on the date stated above, at
7.19Am.
INTERVAL BETWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
81
Years
Months ...........
Days
If under 24 hours
Hours .............
Minutes
13 Usual
Occupation :
Dressmaker
(Kind of work done during most of working life)
14 Industry
or Business :
Clothing
15 Social Security No.
028-16-6743
CapeBreton
Was autopsy performed?
cal Examinehat test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
PARENTS
19 MAIDEN NAME
OF MOTHER
Margaret Maceachern
20 BIRTHPLACE OF
Winthrop
MOTHER (City)
Cape Breton
(State or country)
Nova Scotia
21
Isabelle Mackinnon
Informant
(Address)
556Shirley St., Winthrop
I HEREBY CERTIFY that a satisfactory, standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
(Signature of Agent of Board of Health or other)
1.01
1/12/6/
(Official Designation)
(Date of Issue of Permit)
MARRIED
WIDOWED
or DIVORCEng le
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Myocardial Wear
Due To
(b)
-
nditions contrib- o death but not to the terminal condition given
ed Juris- ion
e :- Chapter 137, of 1954. requires icians to print or the cause or s of death on certificates, and ter 48, Acts of requires Physi- to print or type under signature.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
White
10 SINGLE
(write the word)
Female
That I attended deceased from
[ (Was deceased a
U. S. War Veteran,
No
(Usual place of abode)
To be filed for burial permit with Board of Health or its Agent.
(cito EHPop Convalescent Home No. 142 Pleasant St.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
6
HROP.
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 pers Af 121961 AM 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.
DRM R-301A 1
INSTRUCTIONS FOR ICAL CERTIFICATE
In giving SE OF DEATH
do not enter more than one ause for each (a), (b) and (c)
is does not mean mode of dying, as heart failure, nia, etc. It means lisease, or compli- 15 which caused
nditions, if any, ich gave rise to we cause (a), ting the under- cause last. ng
Conditions contrib- to death but not d to the terminal e condition given ).
e :- Chapter 137, of 1954, requires cians to print or the cause or s of death on certificates, and ter 48, Acts of requires Physi- to print or type under signature.
21.0
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.
Winthrop Community Hospital 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)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
41 Temple Ave
St.
Winthrop
(a) Residence. No.
(Usual place of abode)
Length of stay: In place of death ........... years ... .. months. 1 days. In place of residence. 45 years ... .... months .. .... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Jan ..
11 1961
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
1961
Dec ........ 30 ...
19.5.5 ... , to.I.an ....
11
1-11-
19 ..
61
death is said to
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Victor Emanuel .... Nelson
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
2 yrsAGE96 .... Years.
11. Months ..
28 Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
house work
(Kind of work done during most of working life)
5 yrs 14 Industry
or Business:
own .... home
15 Social Security No.
none
16 BIRTHPLACE (City)
(State or country)
Norway
17 NAME OF
FATHER
Johan Enholm
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Norway
19 MAIDEN NAME Kar ay MaThea
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Norway
Nils Victor Nelson
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Ralph E Mariann (Signature of Agent of Board of Health or other) Luften 1/13/6/
(Official Designation)
(Date of Issue of Permit)
(Registrar)
PARENTS
5 Was disease or injury in any way related to occupation of deceased NO. If so, specify
(Signed)
In. Traunstein
M. 1).
OF MOTHER
unable to obtain
M. Traunstein Jr M. (PRINT'OR TYPE SIGNATURE)]-11- 61
19
73AUsst lett Rd Winthrop Mass
Place of Burial or Cremation (City or Town)
DATE OF BURIAL January 14 1961
7 NAME OF
FUNERAL DIRECTOR
alfred B. March
19
ADDRESS 174 Winthrop St. Winthrop,
Received and filed JAN 13 "". 19
8 SEX
F
9 COLOR
W
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
widowed
I last savueralive on
have occurred on the date stated above, at 1 0.45 A.M.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
Arteriosclerotic heart
(a)
disease
INTERVAL BETWEEN ONSET AND DEATH
Due To
Generalized arterioscler
(b)
osis
Due To
(c)
None
OTHER
SIGNIFICANT
CONDITIONS
None
Was autopsy performed?
No
What test confirmed diagnosis ?
Clinical and Lab.
6 Winthrop Cemetery winthrop, Mass 21 Informant (Address) 8 Temple Avenue, Winthrop
lass
40
To be filed for burial permit with Board of Health or its Agent.
Emilie Martine Nelson(Enholm) Enne Erhole Hexson
2 FULL NAME
(If nonresident, give city or town and State)
(Month)
(Day)
OM-11-59-926662
1
WIFE
Loss
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
...........
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER E
.........
THRON
RULES OF PRACTICE
JAN 3.1961 AM
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
Middlesex
(County)
Winchester
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Winchester
(City or town making return)
Registered No.
10
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Dorothy M. Howe (Marshall)
2 FULL NAME. (If deceased is a married, widowed or divorced woman, give also maiden name.)
834/ H& MMOR AVE 42 Floyd Street
Winthrop,
U. S. War Veteran,
iffra specify WAR)
(a) Residence. No.
(Usual place of abode).
1
4
(If nonresident, give city or town and State)
Length of stay: In place of death
.years.
.. months
...... days. In place of residence
.years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
January
3 DATE OF
DEATH
(Month) (Day) (Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof
of .. "Suritat*"Ether Anesthesia used as anesthetic for closure of perforated te.cum .... caused .... b.y .... cancer ...
5 Accident, suicide, or homicide (specify)
Date and hour of injury
19
Where did Injury occur ?. (City or town and State)
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