USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 20
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
20 BIRTIIPLACE OF
MOTHER (City)
White River Jct.
(State or country)
Vermont
21 Informant Fred.A. Baumeister
(Address)
12 Prospect Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate ul death was filed with me IUMFORE the burial or transit permit was issued: Mass. 8 Camere
(Signature of Agent of Board of Health or, other)
1482 4-4-61
(Official Designation)
(Date of Iaque of Permit)
Vi!
R-301A 1
UCTIONS FOR CERTIFICATE
cíving
OF DEATH ot enter than one for each b) and (c)
al dring. heart failure, Is It means . no compli.
. if any, 111 111 10 41 (4). the under- euse last.
eath but not the irrminal adition given
Chapter 117, 024, requires s to print or rausr or death on
C
430.
COM-5-57-920345
| 14 1961
PLACE OF DEATH
3 DATE OF
DEATH
April
2
1961
(Year)
(Month) (1)ay)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) ARTERIOSCLEROTICHEART Di'S.
INTERVAL BETWEEN ONSET AND DEATH 15yrs
Due To GEN ARTERIOSCLEROSIS (b)
20grs
Due To (c) ..
OTHER
SIGNIFICANT
CONDITIONS
RHEUMATOIDARTHRITIS LOUIS
16 BIRTIIPLACE (City)
(State or country)
VERSIONI.
Mass
10a If married, widowed, or divorced
IlUSHAND of
(Give maiden name of wife in full)
(Was deceased a U. S. War Veteran, if so 'specify WAR)
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death years _____ months
CERTIFICATE OF DEATH
Registered No. 03235
6
5
A TRUE COPY ATTESTI
Charles H. Mackie
HECEVED
City Registrar
TOWA
CFF
1 .
ERK
6
-
OP
JUN 1 41961 AM
PLACE OF DEATH
BOSTON (County) MASS
(C'ity or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
OUT - OF - TOWN 91
To be filed for burial permit with Board of Health or its Agent.
Registered No.
CHILDREN'S HOSPITAL MEDICAL CENTERIf death occurred in a hospital or institution. St.7 give its NAME instead of street and number)
HARRIS RUDGIN
2 FULL. NAME ..
(First Name)
(Middle Name)
(Last Name)
( If deceased is a married, widowed or divorced woman, give also maiden name.)
171 SHORE DRIVE, WINTHROP, MASS
St.
( If nonresident, give city of town and State)
Length of stay: In place of death. ..... years ..
.. months.
days. In place of residence ..
4 years 10 months 21 days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATI
APRIL. 7,
196.1
( Month)
(Day)
(Year)
8 SEX
MALE
9 COLOR
WHITE
MARRIED
WIDOWED
or DIVORCED
SINGLE
4 I HEREBY CERTIFY, That I attended deceased from
APRIL .7 ...... , 6.1 ....... .. APRIL ..........
161
....
I last saw hi malive on APRIL 7 61 ...... , death is said to have occurred on the date stated above, at 5:15pm. INTERVAL BETWEEN GNSET AND
DEATHI WAS CAUSED BY : IMMEDIATE CAUSE
(a) SUB ARACHNOID
HEMORRHAGE.
Due lo (b)
INTRACRANIAL METASTASES
Due To
(c)
DISSEMINATED NEUROBLASTOMA.
PEAR
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
YES-
What test confirmed diagnosis?
AUTOPAY.
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
4 Silvestro
M. D
PERITONE
( Address)
300LONGWODER THESIGNATUAPRIL 8, 61
Date.
· TIFERBETH ISRAEL OF WINTHROP-EVERETT
Place of Burial or Cremation
(City or Town)
7 NAME OF
FUNERAL DIRECTOR
ARNOLD GOLOU
ADDRESS 1668 BERLINSi BRUJeANIE
Received and Gled ........... !
2
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
BOSTON MASS
(State or country)
19 MAIDEN NAME
OF MOTHER
LOUISE BARSKY
20 BIRTHPLACE OF
MOTHER (City)
(State-or country)
BOSTON MASS
HAROLD KOVITZ
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me) BEFORE the burial or transit permit Sugsich conad NJ16244
( Signature of Agent of Board of Health or other) april 9 196/
(Official Designation)
(Date of Issue of Permit)
UCTIONS OR CERTIFICATE
iving F DEATH t enter han one for each b) and (c)
's mot medm of dying. cars failure. tr. It means . or compli- kirk caused
s. i! amy, vr rise to anse (a). he under. use lust.
ions contrib. uth but not the terminal dition given
193.4
C
Chapter (37. 754. lequieres s to print or cause or t death on outu ales, and 48. Arls of ures Physi- print or type er signature.
SDICTION EED BY IL EXAMINEKY 14 1961 028145
PHYSICIAN - IMPORTANT [ (Was deceased a U. S. War Veteran, (if so specify WAR) No
...
10 SINGLE
(write the word)
10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
Il IF STILLBORN, enter that fact here.
12
AGE ..
.....
Years 10 Months 2/ Day:
If under 24 hours
„Hour .......... Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business :
-
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country)
WINTHROP MAS5
17 NAME OF
FATHER
SIDNEY RUDEIM
DATE OF BURIAL
APRIL
9
196J
21
Informant
(Address)
IL LEWIS TERRACE; WIMTHAOA
-
R-301A 1
No.
(a) Residence. No. (I'suai place of aluxle) N HOSPITAL 5 Hours 20MIns.
'A TRUE COPY ATTEST:
Charles it. Mackie
City Registrar
TO
OF
-1
/ 1:10
1
LEKK
1 .-
6
WINTHROP.
JUN 1 41961 AM
X PLACE OF DEATH
R-301A - Suffolk (County)
Boston (City or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
OUT - OF - TOWN To be filed for burial permit with Board of Health or its Agent.
Registered No. 03557
2 FULL NAME .
Mr. Robert W. Haddow
( First Name)
(Middle Name)
(Last Name)
[(W'ss deres.ed a U. S. War Veteran.
{if so specily WAR) No
(Il deceased is a married, widowed or divorced woman, give also maiden name.)
293 Revere Street
St.
Winthrop. Mass.
( If nonresident, give city of town and State)
Length of stay: In place of death.
...
.years
23
months.
.. days.
In place of residence.
years.
months
... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATHI
April
11
196 1
(Month)
(l)ay)
(Year)
4I HEREBY CERTIFY ..
March
19
19 61 10
April 11
That
attended deceased
19
I last saw |
im
alive on April 11
19.61
death is said to
have occurred on the date stated above, at 1: 35 A. .m.
(or) WIFE of
(Husband's name in full;
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) INTRAPULMONARY HEMMORKAGE
mı. if amy. - l'ue To (b) CIRRHOSIS OF LIVER.
Due To (c)
OTHER
SIGNIFICANT RENAL SHUTDOWN,
CONDITIONS
3 days
Was autopsy performed? YES.
What test confirmed diagnosis? lwer hopsin, audurasy
S Was disease or injury in any way related to occupation of deceased? If so, specily Ia
(Signed)
Macurail Cont
MAURICE J. ELUVITZ
(PRINT OR TYPE SIGNATURE)
M. D
(Address) NEW ENGI DEACONESS, Die 4/11 1961
6 Verreen Cemetery Erichton
Place of Burial or Cremation
(City of Town)
DATE OF BURIAL
April 13,
EI
19
21 Emily Haddow Kcaleor
Informant
(Address)
35 Bothwell R.C. SNCCon
2 -: tiscate of death
insit permas wca Losund:
(Signature of Agent of Board of Health or other)
A16327
Aprilia, 1941
(Official Designation)
(Date of Issue of Permit)
-
11 IF STILLBORN, enter that fact here.
12
36
If under 24 hours
AGE
Years.
MonthE ... mmm ... Daya
13 Usual
Occupation:
Service Dent.
14 Industry
or Business :
oil Burner
15 Social Security No. ....
028-12-2200
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
Wilson Haddou-
18 BIRTHPLACE OF
Scotland
FATHER (City)
(State or country)
19. MAIDEN NAME
OF MOTHER
Emily Skugin
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Latvia
1
7 NAME OF
FUNERAL DIRECTOR
Bernard S. NcNamara
ADDRESS
110 washington St. Brighton
APR 1+ 1961 19.
(Registrar)
928145
1 14 1961
JURISDICTION WAIVED
No.
New England Deaconess Hospital
f(If death occurred in a hospital or institution. St. Į give its NAME instead of street and number) ...
PHYSICIAN - IMPORTANT
RUCTIONS FOR CERTIFICATE
giving OF DEATH ul enter than one for cach (b) and (c)
ies Mot meJn of dying, heart failure. ti. It means , or compli- which caused
ove rise to rouse (a). the under- cause last.
liomi contrib. roth but mot the terminal ndition given
581
Chapter 137. 1954. requires Đọ từ príng P cause or of death on rt Fiates. and
PARENTS
10a If married, widowed, or divorced
HUSBAND of
an
(Give maiden name of wife la full)
IKIERVAL BETWEEN ONSET AND DEATH 2 hours
- 1yr.
8 SEX
Nale
9 COLOR
white
10 SINGLE. - ( write the word)
MARRIPI .. .
WIDOWED
of DIVORCED
(a) Residence, No ( l'anal plaer of abode)
5
Received and fed
de. signature. 1, C.
HEREBY CERTIFYthe Sjed with me BEF Jefe Digory Standard
Boston
(Kind of work done during most of working like)
'A TRUE COPY ATTEST?
Charles it mackie
City Registrac
TOM
,i= ()
7: 12. 1
3 LERK
1
0
8
WINTHROP MA
JUN 1 41961 AM
X PLACE OF DEATH
SUFFOLK
(County)
BOSTON
(City or Town)
The Commonwealth of Mannachusetts 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. 03813
Registered No.
[(If death occurred in a hospital or institution.
St. { give its NAME instead of street and number)
2 FULL NAME
Jennie Gruszecki
(First Name)
(Middle Name)
(Last Name)
(if so specify WAR)
(11 deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 142. Pleasant Street (l'sual place of abode)
............
St.
Winthrop, .... Massachusetts.
(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
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
April
18
1961
(Year)
(Month)
(Day)
That we attended deceased from
19 ... 6.1
WE last saw Her.alive on ..... April ... 18. 19 ..... 6.1 death is said to have occurred on the date stated above, at 3:30 pm. INTERVAL BETWEEN
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) OBSTRUctive Emphysema
Due To
(b) Acute TRAcheo Bronchitis
Due To PURutENT. (Staph . )
(c)
OT11 F.R
SIGNIFICANT
CONDITIONS
Was autopsy performed?
yes
What test confirmed diagnosis?
Autopsy
S Was disease or injury in any way related to occupation of deceased? If so, specily
(Signed)
M. D
Charles.L .. Clay,. M. D.
(PRINT OR TYPE SIGNATURE) April 18 61
(Address) Ass't. Dir., Mass. Gon'l. Hocp. Date.
St. Michael's - Bal 6 Place of Burial or Cremation (City or Town) abril - 22 DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
7 H Pochard! Cambri De Mars.
ADDRESS
APR 26 1967
-mar
(Registrar)
PARENTS
16 BIRTHPLACE (Citli (State or country)
NAME OF FATHER
Kulcan 0
18 BIRTHPLACE
FATHER (City
(State or country)
Polan?
19 MAIDEN NAME OF MOTHER Lathering Banyak
BIRTHPLACE Prieten
(State or country)
MOTHER (
21 Informant
Eder. Gruszechi - S (Address) Jose Check
I HEREBY CERTIFY that a satisfactory standard chilicase of death wu fled with me BEFORE the burial or transi: pernht wn imued:
--
-
(Signature of Agent of Board of Health or other)
1725
4-20-61
(Official Designation)
----
(Date of Issue of Permit)
X
dois
10a Il married, widowed, or divorced HUSBAND of
(GivOmtiden name of wife in full)
(or) WIFE of
(Hr and's name in f. ))
11 IF STILLBORN, enter that fact here.
12
63
Years.
Months ......... Days
If under 24 hours
Hours
... Minutes
13 Usual
Occupation:
(Kind of work done during most Of Working with
14 Industry
or Business :
15 Social Security No.
2
Chapter 137. 1954, requires ns to print or e cause or of death on rtifcates, and 48, Aets of quires Physi- print or :ype der signature.
directen se only N 16 196
R-301A 1
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each b) and (e)
es mot meGN of dying. røri failure. Ir. It means , or compli- hich caused
wr. if eny. ave rise to amse (€). the under- anse last.
lions contrib. rath but not the terminal adition given
1928145
No.
MASSACHUSETTS GENERAL HOSPITAL
PHYSICIAN - IMPORTANT
[ ( Was deceased a { U. S. War Veteran.
SEX
Hende
9 COLOR
Colite
10 SIE CLE
(write the word)
41 HEREBY CERTIFY,
April ..... 11.
., 19 ...
61 to April 18
HOURS 9 days
'A TRUE COPY ATTEST: Charis it Mackie City Registrar
R-30.A
PLACE OF DEATH
Suffolk
(County)
Boston
(City or Town) ..... ......
The Commonwealth of Cansarhusetia JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
OUT - OF - TOWN
To be filed for burial permit with Board of Health or its Agent. 03856
Registered No.
f(If death occurred in a hospital or institution,
( give its NAME instead of street and number) PHYSICIAN - IMPORTANT
2 FULL NAME
Raleigh
Calvin
BROWN
(( Was deceased U. S. War Veteran,
(if so specify WAR)
WII
(It deceased is a married, widowed or divorced woman, give also maiden name.)
120. Croot Avo.
Winthrop, Mass.
Length ot stay: In place of deathG. years. O .. months ... ... days. In place of residence. 3 .. years
... months ........ .. days
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Malo
9 COLOR
Whito
10 SINGLE
MARRIED
(write the word) Married or DIVORCED
10a If married, widowed, or-diyorced
HUSBAND of
Alma
(Give maiden name of wife In full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
63
11
... Years
.Months
24 Days
Minutes
13 Usual
Occupation :
monitor
(Kind of work done during most of working life!
14 Industry
or Business :
Logan Airport, Boston, Mass.
15 Social Security No. ......
Cesar
16 BIRTHPLACE (City)
(State or country)
Illinois
17 NAME OF
FATHER
Elonzo
Elenco Proim
18 BIRTHPLACE OF
FATHER (City)
Casoy
M. D
(State or country)
Illinois
19 MAIDEN NAME
OF MOTHER
Docia can not be learne
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Illinois
Informuant 21 V. A. Hospital records, 150 S. (Address) Huntington Jm Ponten, Maca
I HEREBY CERTIFY that a satisfactory standard certificate of death was bled with me BEFORE the burial or transit permit was asked: NO mcnamara
ADDRESS APR 25 1961 G.CO.
Receiver and hled
Charles It Machen
(Registrar)
PARENTS
Cambridge Com., Cambridge, Mass.
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL
April 24
67
19
7 NAME OF
FUNERAL DIRECTOR
A. E. Long & Son
1979 Massachusetts Ave .. Cambridge,
14 1961 ....
928145
INTERVAL BETWEEN ONSET AND DEATH 2 yra
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Carcinoma of the lung with
(a)
motastadio-to-the-brain.
....
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
N.o
What test confirmed diagnosis?
Clinical & Lab Finding
S Was disease or Injury in any way related to occupation of deceased? If so, specify
John S. Letelton MD
(Signed)
John.S .Ilton (PRINT OR TYPE SIGNATURE)
(Address) VAR, Boston, Macs . Due Apr. 21 19 67
67
19 ...
C death is said to
have occurred on the date stated abr,ve, at
.... m.
3 DATE OF
DEATH
Apr ..
20
1961
(Month)
(Day)
NA (Year)
That Iattended deceased from
4 1 HEREBY CERTIFY,
.Apr ...... 20
19.
.61
20
., to ..
( First Name)
(Middle Name)
(Last Name)
JCTIONS OR CERTIFICATE
iving OF DEATH t enter han one for each b) and (c)
of dying, cart failure. sc/ 10 means or ror pli. kich oused
-
0 s. if any, ve rise to ause («), he under- last.
ions contrib- cath but mot the terminal dition given
.C .
Chapter 137, 1954. requires ns to print or e cause or of death on tificates, and 48. Acts of quires Physi- print or type der signature. diçal minor clines risdioti
No.
Veterans Administration Hospital
(a) Residence. No.
( Usual place of abode)
(If nonresident, give city or towr and State)
(Siumnature of Agent of Board of Health or other)
1755
4-21-61
(Official Designation) (Date of Issue of Permit)
v.B.
If under 24 hours
A TRUE COPY ATTEST: Charles it mackie City Registrar
TOW
OF
11 12. 1
OFFICE
NIN
CLERK
Co
...
WIN
6
HRO
JUN 1 41961 AM
R-301A
PLACE OF DEATH
Suffolk (County)
Boston
....
(('ity or Town)
The Commonwealth of Cancerqunetto JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
OF - TOWN To be filed for burial permit with Board of Health or its Agent.
Registered No. 03910
[(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 decraved is a married, widowed or divorced woman, give also maiden name.)
€
4 Linden
.St. Winthrop, Mass.
1.enxth of stay In place of death years ..... ...... months 16lays. In place of residence .. 70
.years
.. months ..
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
April
20
1961
(Month)
(1)ay)
(Year)
41 HEREBY CERTIFY , ThatVE attended deceased from
19.61
April .... 4
19.61 . .. April 20
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX .. , death is said to
have occurred on the date stated above, at
4 .: 25.P.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
1. Bronchopneumonia
INTERVAL BETWEEN ONSET AND DEATH daya
(b)
12. Congestive heart failure
days
Due To (1)
OTHER
SIGNIFICANT
Ancmia
unk
CONDITIONS
Was autopsy performed?
.No
What test confirmed diagnosis?
Clinical & Lab Finding;
(Signed)
Robert t Surlar
Robert K. Savpla
(PRINT OR TYPE SIGNATURE)
(Address) VAH Boston, Mass.
April 20 1961
6 ..
Winthrop Cem., Winthrop Mass.
l'lace ní Burial or Cremation
(City or Town)
DATE OF BURIAL April 24 61
19
7 NAME OF
FUNERAL DIRECTOR
Arthur O'Maley
79 Atlantic Streot
ADDRESS Winthrop, .... Lass.
Received any filed APR 2 5 1961 Charlesit Mackie.
(Registrar)
PARENTS
17 NAME OF FATHER William B
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country) Massachusetts
19 MAIDEN NAME
OF MOTHER
Johanna Ready
20 BIRTHPLACE OF MOTHER (City) (State or country)
21 VA Hospital Records, 150 South
Informant (Address) Huntington Avo., Posto Praca
I HEREBY CERTIFY that a satisfactory standard certificate of death Wasfiled with me ALITIS the budebuy - west:
(Signature of Agent of Board of Health or other)
916556
4/23/66 .........
(Official Designation)
(Date of Issue of permit)
UCTIONS OR CERTIFICATE giving OF DEATH t enter han one for each b) and (c)
's not mean dying. earn failure. in cumpli. caused
&. if any, ur rise to usse (a). kr under. tuJe last.
joms contrib- ath but not the terminal dition given
Chapter 137. 954. requires s to print or cause or of death on tificstes, and 48, Acts of uires Physi- print or type er signature. C.
14 1961
28145
101
CERTIFICATE OF DEATH
No.
Veterans Administration Hospital
RAYMOND J. KENNEY
[( Was deceased a U. S. War Veteran. [if so specify WAR)
(write the word)
8 SEX
Malo
9 COLOR
Whito
10 SINGLE
MARRIED
WIDOWEJidomed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name la full)
11 IF STILLBORN, enter that fact here.
12
AGE .... 7.0 Years
5.Months
10Days
If under 24 hours
Hours ............. Minutes
13 Usual
Occupation :
Machinist
(Kind of work done during most of working life)
14 Industry
or Business :
15 Social Security No.
Newbury port
16 BIRTHPLACE (City)
(State or country)
Massachusetts
5 Was disease or injury in any way related to occupation If so, specify
do deceased?
OUT.
.. .
(a) Residence. Nu. ( ['sual place of abode)
(If nonresident, give city of town and State)
A TRUE COPY ATTEST:
Charles A Mackie City Registrar. ECE VED
TOW
LERK
1
6
JUN 1 41961 AM
R-301A 1
PLACE OF DEATH
SUFFOLK
..... (County)
BOSTON
(City or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
OUT- OF - TOWN To be filed for burial permit with Board of Health 15972
Registered No.
No.
MASSACHUSETTS.GENERAL.HOSPITAL
Nora Rawston
2 FULL NAME
(First Name)
(Middle Name)
(Last Name)
lif wo sperify WAR)
NO
(a) Residence. No.
( l'sual place of abode)
Length of stay. In place of death
years
months
1 Q.days. In place al residence
25
.. years
month ...
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
April 23, 1961
DEATII
(Month)
(D)av)
(Year)
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
Apr.
13
61
'Apr. 23
.....
19
we last saw er alive on Apr. 23
61
19
death is said to
(Give maiden name of wile in full)
have occurred on the date stated above, at
7:00A.m.
INTERVAL DETWEEN ONCET AND
11 IF STILLBORN, enter that fact here.
24 H
LAGE60
Years .....
Months.
.. Day?
If under 24 hours
... Hours ........... Minutes
Due To
(b) Cerebral ombolus
Due To Myocardial infarction and
(c)
mural thrombus, It. vent
10 daly's Industry
or Business:
U.S. Service Store
15 Social Security No.
1.5-16-9572
Fall River
What test confirmed diagnosis?
autopsy
S Was disease or injury in any way related to occupation of deceased? If so, specily .
(Signed)
@hClay
M. D
Charles L ... Clay,.J. D.
(PRINT OR TYPE SIGNATURE)
(Address) Ass't. Die., Mass. Gen' Hosp. Date Apr. 23. 61
Winthrop .... Cemetery Winthrop
6
l'lace of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 26
19.61
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O' Maley
ADDRESS Winthrop Mass
Received and filed
19
(Registrar)
PARENTS
17 NAME OF
FATHER
Austin Tierney
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Annie Maloney
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21
Robert Rauston
Informant
(Address)
459 Winthrop St., Wintbrer
I HEREBY CERTIFY that a satisfactory standard certificate of death way filed with me BEFORE the burial or transit permit was issued: Jane
(Signature of Agent of Board of Health or other)
1 796
4-25-61
(Official Designation)
(Date of Issue of Permit)
ICTIONS OR CERTIFICATE
iving F DEATH t enter han one for each b) and (c)
's not mean of dying, cars failure. tr. It meani or compli. hick caused
s, if any, ve rise io ause (a). he wasder. use last.
ions contrib. ath but not the terminal dition given
Chapter 137, 954. requires ns to print or cause or of death on tihcates, and 48. Acts of utres Physi- print or type er signature. n. a. irector e only 174 1961 928145
11 } K
FKTIFY
That we attended deceased
19
10a Il married, widowed, or divorced
HUSBAND of
(or) WIFE ol
Robert Rawston
(Ilusband's name in lull)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) Infarction, It. cerebral hemisDEATH
pho re-
24 hrby Usual
Occupation :
Clerk
(Kind of work done during most of working life)
OTIIER
SIGNIFICANT
CONDITIONS
16 BIRTHPLACE (City)
(State or country)
Mass
Was autopsy perfnrmed?
Yes
S(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. ..
(1( deceased is a married, widowed or divorced woman, give also maiden name.) 457 Winthrop St. Winthrop, Mass.
(If nonresident, give city of town and State)
TRUE COPY ATTESTI Charles it. mackie City Registrar
RECEIVED
OF
TOWA
OFFi.
N !!
LERK
.
6
WINTHROR
JUN 1 41961 AM
X
PLACE OF DEATH
SUFFOLK
(County)
BOSTON
(City or Town)
The Commonwealth of flassarhusrits JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
OUT - OF - TOWN To be filed for burial permit with Board of Health- or its Agent. 103
041017
No. MASSACHUSETTS GENERAL. HOSPITAL William John Mac Queen First Name) (Middle Name) ( Last Name)
[(If death occurred in a hospital or institution. St. Į give its NAME instead of street and number) PHYSICIAN - IMPORTANT [ ( Was deceased a {U. S. War Veteran. (if so specify WAR) ....
( If deceased is a married, widowed or divorced woman, give also maiden name. )
31 Charles Street
Winthrop, Massachusetts SI
(a) Residence. No.
( l'sual place of abode)
( If nonresident, give city of town and State)
Length of stay:
In place of death.
years.
months
1 1days. In place of residence
40
ears.
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
April
26
1961
(Month)
(Day)
(Year)
April 15 19.
CERTIF
61
to. ..
19
HUSBAND) of ...
Joyce Helena Baker
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILL BORN, enter that fact here.
AGE.
.7.8Years ...
3 Months 13 Days
If under 24 hour.
Ilours
Minut
Due To
(Thrombophlebitis, leg veins
Due To (c)
OTHER
SIGNIFICANHypertensive heart disease
CONDITIONSCerebral infarcts
Was autopsy performed?
yes
What test confirmed diagnosis? .. autopsy ..
S Was disease or Injury in any way related to occupation of deceased?
If so, specify
(Signed)
Charles L. Clay. L.D.
( PRINT OR TYPE SIGNATURE)
(Address) Aus's Dir, Mass Gon' Hosp. Date April 26 61
Winthrop Cemetery Winthrop, Mass 6
Place of Burial or Cremation (City of Town)
DATE OF BURIAL April 29,1961
7 NAME OF FUNERAL DIRECTOR Ciefred 13.Mars
ADDRESS
174 Winthrop St. Winthrop
MAY 2 1961 4.19
Charles & Mach
( Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Whycocomah
M. D
(State or country)
Nova Scocia
19 MAIDEN NAME
OF MOTHER
Sarah Maclean
20 BIRTHPLACE OF
Whycocomah
MOTHER (City)
(State or country)
Nova Scocia
Mrs ...
John W MacQueen
Informant
(Address)
31 Charles St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was bled with me BEFORE the burial or transit permit was loved
Mass.
Drmchamada
(Signature of Agent of Board of Health or other)
1854
4-28-41
(Official Designation)
(Date of Issue of Permit)
4.13
R-301A 1
CTIONS
ERTIFICATE
ving P DEATH enter an one or each ) and (c)
not mean of dying. art failure. . It means or compli- ich caused
. if any, e rise to
-
e under- ue last.
-
as contrib- tà but not he terminal ition riven
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.