USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 22
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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 (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.
HERE'SSC
5 TOF
6
ien ?.
JUN -51961 PM
x
PLACE OF DEATH
Suffolk (County)
INS
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.
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,
{if so specify WAR)
No
( If deceased is a married, widowed or divorced woman, give also maiden name.)
49 Hermon Street
(a) Residence. No.
(Usual place of abode)
2
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
June
7
1961
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, That Iattended deceased from
6/4/
1961
to ...
6/7/
61
I last saw He .. Y .. alive on
6/7/
19.61
death is said to
have occurred on the date stated above, at
7:30 Ppm.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) Cerebral Hemorrhage
Due To
(b)
Hypertension
Due To
(c)
OTHER
SIGNIFICAN Arteriose levotic Heart Disease
CONDITIONS
Atrial Fibrillation
lomos.
Was autopsy performed?
NO
What test confirmed diagnosis?
Clinical
5 Was disease or injury in any way related to occupation of deceased?
If so, specify .
No
(Signed)
Charles Liberman
M. D
Charles
Liber mani
(PRINT QR TYPE SIGNATURE)
(Address)
Winthrop, Mass
Date ..
6/7/
1961
6
Winthrop Cemetery
Winthrop
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
June 10, 19 67
7 NAME OF
FUNERAL
DIRECTOR
Arthur .... J ........ 0."Maley.
Winthrop, Mass.
ADDRESS
Received and filed JUN 12-1961 .. 19.
( Registrar )
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Finland
19 MAIDEN NAME
OF MOTHER
Margaret Mckeon
20 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country)
Mass
21 Eileen Wilson
Informant
(Address)
49 Hermon St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: DolphE. Sercanni (Signature of Agent of Board of Health or other)
2.0.
June 8/1961
(Official Designation)
(Date of Issue of Vermit)
MARRIED
WIDOWER.
or DIVORCEIdOwed
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Albert J. Mulrey
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
72
Years ...........
Months ...
.Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
Housekeeper
(Kind of work done during most of working life)
14 Industry
or Business:
.Home
15 Social Security No.
Charlestown
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
Joseph Wilson
:- Chapter 137, f 1954. requires ians to print or the cause or of death on certificates, and :r 48, Acts of requires Physi- :o print or type inder signature.
TRUCTIONS FOR L CERTIFICATE
giving OF DEATH not enter : than one e for each (b) and (c)
does not mean de of dying, heart failure, etc. It means ise, or compli- which caused
ions, if any, gave rise to cause (a), the under- cause last.
ditions contrib- death but not o the terminal condition given
50-928145
M R-301A 1
To be filed for burial permit with Board of Health or its Agent.
Winthrop Community Hospital
No. Julia (Wilson) Mulrey
2 FULL NAME
(First Name)
(Middle Name)
(Last Name)
St.
(If nonresident, give city or town and State)
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
INTERVAL
BETWEEN
ONSET AND
DEATH
3days
2 yrs,
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE FT
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1.
-.
JUN 1 2 1961 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.
×
:00
M R-303 A
1
(City or Town) PLACE OF DEATH Suffolk County)
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.
112
No
10 Surfside Live
St.
§ (If death occurred in a hospital or institution,
( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
[(Was deceased a
(Last Name)
U. S. War Veteran,
[if so specify WAR)
No
(If deceased a married, widowed or divorced woman, give also maiden name.)
10
Surfside ave Winthrop.
Man
( If nonrendent, give city or town and State)
Length of stay: In place of death. .. years. .. months. days. In place of residence. 38years
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
F
10 COLOR
White
11 SINGLE
(write the word)
MARRIED
WIDOWED Single
or DIVORCED
lla If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
5 Accident, suicide, or homicide (specify)
Date and hour of injury
.19
IF ACCIDENTAL, was injury causally related to the death?
Where did
Injury occur ?
12 IF STILLBORN, enter that fact here.
13
69
AGE.
Years ..
Months ..........
Days
If under 24 hours
Hours
.Minutes
14 Usual
Occupation :
Clerk
(Kind of work done during most of working life)
15 Industry
or Business :
Brine's Sporting Goods Co.
16 Social Security No.
032-03-3937
17 BIRTHPLACE (City)
(State or country)
Mass.
Somerville
18 NAME OF
FATHER
Charles Edward Stevens
19 BIRTHPLACE OF
St. Johns
FATHER (City)
(State or country)
N.B., Canada
20 MAIDEN NAME
OF MOTHER
Mary Emma Armstrong
21 BIRTHPLACE OF
MOTHER (City)
Lunenburg
(State or country)
Nova Scotia
22 Mrs. Mary E.Taylor
Informant
(Address)
10 Surfside Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
96.0.
June 12, 1961
(Official Designation) (Date of Issue of Permit)
(Registrar)
PARENTS
............... , M. D.
.... M ...............
11
1961
Malden
(City or Town)
1961
8 NAME OF
FUNERAL DIRECTOR
FRANK H. CARR
ADDRESS
79 Elm St. Charlestown
Received and filed
JUN 12-1961
19.
2 FULL NAME (a) Residence. No. (Usual place of abode) MEDICAL CERTIFICATE OF DEATH 3 DATE OF DEATH (City or town and State) Manner of (Specify type of place) Injury (How did injury occur ?) Nature of Injury (Signed) Michael A ...... Luongo ......... (Painfor Type Signature) Boston (Address) Date 6 Holy Cross 7 Place of Burial, or Cremation. If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. of Death. See reverse side for additional information. See also Chap. 38, §§ 6, 20; Chap. 46, §§ 9, 10; Chap. 114, DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF §§ 44-48. DATE OF BURIAL June 13. ٢١ 50M-6-60-928145 E N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of While at work? Was autopsy performed ?
(June (Month) (Day) (Year)
10 1961
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.)
ARTERIOSCLEROTIC HEART DISEASE ACUTE CONGESTIVE HEART FAILURE
Did injury occur in or about home, on farm, in industrial place, or in public place ?
6 Was disease or injury in any way related to occupation of deceased ?
If so, specify/ ...
(First Name) (Middle Name)
Stevens
months
.. days.
VIL
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
OF TOWN
RANK, RATING
NIW
3
ORGANIZATION AND OUTFIT
ERK
7
5
6
TROP MAS
JUN 1 21961 PM
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.)"
SERVICE NUMBER
PLACE OF DEATH
Suffolk (County)
PENSI
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.
113
[(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)
5. Hillside Avenue
St.
(If nonresident, give city or town and State)
Length of stay : In place of death. .years .. months. 4 days. In place of residence. 43
years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED Married
WIDOWED
or DIVORCED
10a If married, widowed, or divorced Agnes Brown
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
81
2
15
AGE
Years
Months
Days
If under 24 hours
Hours.
.Minutes
8 yrs 13 Usual
Occupation :
Engineer
14 Industry
or Business :
architectural
15 Social Security No.
011-01-0396
Lowe II
16 BIRTHPLACE (City) (State or country) Mass
17 NAME OF FATHER Frederick Munn
18 BIRTHPLACE OF
FATHER (City)
Sandy Hill
(State or country)
New York
19 MAIDEN NAME
OF MOTHER
Emeline Caufield
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
Lowell
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
June 16
19 ... 61
7 NAME OF
FUNERAL DIRECTOR
Howard S Reynolds
Winthrop, Mass
ADDRESS
Received and filed JUN 2-0 1961 .19
( Registrar)
PARENTS
Agnes Munn
21
Informant
(Address)
5 Hillside Ave.
Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Lisanne
(Signature of Agent of Board of Health or other)
4,0 6/16/6/
l (Official Designation)
(Date of Issue of Permit)
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
es not mean of dying, heart failure, etc. It means e, or compli- which caused
ns, if any, ave rise to cause (a), the under- cause last.
tions contrib- leath but not the terminal ndition given
Chapter 137, 1954, requires ns to print or he cause or of death on rtificates, and 48, Acts of quires Physi- print or type der signature.
-928145
2 FULL NAME Ernest Gibson Munn ( First Name) (Middle Name) (Last Name) (1f deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
June
14
196I
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
8 Sept 19 58
to
That I attended deceased
14
June
19
1 last saw h ........ alive on
death is said to
have occurred on the date stated above, at
1:10 Pm.
INTERVAL BETWEEN ONSET AND DEATH 1 yr
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Carcinomatosis
(a)
Due To
Carcinoma of Larynx
(b)
Due To
(c)
OTHER SIGNIFICANT CONDITIONS
None
Was autopsy performed?
No.
What test confirmed diagnosis?
Biopsy MGH 1959
5 Was disease or injury in any way related to occupation of deceased? IO. If so, specify. Ene: Arthur CO. Murray, M. D Arthur C. Murray, M. D. (PRINT OR TYPE SIGNATURE)
(Address) Winthr ..... as.S. Date .. 15 June 61
6
Edson
Lowell
Registered No.
No. ...
Winthrop Community Hospital
R-301A 1
3 DATE OF
DEATH
June6I
(Kind of work done during most of working life)
RECE VED
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
OFFI.
2 ERK
...
TH
JUN- 2.01961 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.
PLACE OF DEATH
Suffolk (County)
CANSi
Winthrop, Mass. (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. 114
Winthrop Community Hospital [(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) No.
2 FULL NAME Louise (Ingalls) I. Griffin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
[if so specify WAR)
(a) Residence. No. 15.VillaAve,Winthrop , .... Mass .... St. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death .............. years .............. months.
3 ... days. In place of residence ...... Oyears ...
.months .............. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED TAI
or DIVORCEWidow
10a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
Arthur Eugene Griffin
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
8.5Years
8
Months.
.5 ..... Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business :
None
15 Social Security No.
None
16 BIRTHPLACE (City)
Boston , ...... Mass ..
(State or country)
17 NAME OF
FATHER
Frederic C. Ingalls
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston, Mass.
19 MAIDEN NAME
OF MOTHER
Mary Munro ( Ingalls)-
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Paspbiac Canada
21 Dora M. Ingalls (sister)
Informant
(Address)
15 Villa Ave. Winthrop
7 NAME OF
FUNERAL DIRECTOR
Alfred B. Marsh
ADDRESS 174 Winthrop St. Winthrop
Received and filed
JUN 2 0 1961
19
(Registrar)
PARENTS
myron . Kung
(Signed)
M. D.
MYRON UN. KING MOD
(PRINT OR TYPE SIGNATURE)
6/17 /06/
(Address) 222 PLEASANT WINTHROP MYASS Date.
6
Winthrop Cemetery,
Winthrod
Place of Burial or Cremation
(City or Towass .
DATE OF BURIAL June 20 ,1961 19
2 YRS
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
PARTIAL UREMIA.
3 DAYS.
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
INTERVAL
BETWEEN
ONSET AND
DEATH
3 DAYS
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
CEREBRAL VASCULAR
ACCIDENT
(b)
ions, if any, gave rise to cause (a), the under- cause last.
ditions contrib- death but not o the terminal condition given
Chapter 137, 1954. requires ns to print or e cause or of death on rtificates, and 48, Acts of quires Physi- print or type der signature.
C
11-59-926662
6
17
1961
(Month)
(Day)
(Year)
4 I HEREBY
CERTIFY
That I attended deceased from
61
4/26
19.61
to
6/17
I last saw h.ERalive on
6/12
1961
death is said to
have occurred on the date stated above, at
.. m.
9A
ARTERIO-SCLEROTIC HEART
DISEASE + KIDNEY DIS.
M R-301A 1
TRUCTIONS FOR CERTIFICATE
1 giving OF DEATH
not enter than one e for each (b) and (c)
does not mean de of dying, heart failure, etc. It means se, or compli- which caused
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or . transit permit was issued: Ralph E Sirianni af (Signature of Agent of Board of Health or other) H.C. 6/20/61
(Official Designation)
(Date of Issue of Permit)
V.IL
.Houserife
3 DATE OF
DEATH
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
ERK
.C
HROBY
JUN 2 01951 AM
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease un- related to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor - tant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa - tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Chil- dren not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook- hotel, etc. For a person who had no occupation whatever write none.
X PLACE OF DEATH
Suffolk (County) 1
Winthrop (City or Town)
Winthrop Community Hospital No.
§(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Mary Malloy
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(if so specify WAR)
(a) Residence. No.
98 Bradstreet Avenue
St.
Revere Mass
(Usual place of abode)
(If nonresident, give city or town and State)
............. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
June 21 1961
DEATH
(Month)
(Day)
(Year)
That I attended deceased from
19
6
10a If married, widowed, or divorced HUSBAND of
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