Town of Winthrop : Record of Deaths 1961, Part 4

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 4


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death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner nr cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L .. (Tercentenary Edition).


Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6 . as amended by Chap. 632, Sec. 4, Acts of 1945.


No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the derk of the town where the body is to be buried or the funeral is to. be held, or from a person appointed to have the care of the cemetery or burial ground in. which the interment is made.


Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


TORULES OF PRACTICE


The fulfillment of the purpose of, these laws calls for the observance of the follow- ing rules of practice bill 1


(1) Attending-physicians wint certify to such deaths only as those of persons to whom they have given bedside came during a last illness from disease unrelated to any form offinjury. 2120!


(2) Board of Health physicians will certify to such deaths only as those of persons whol 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 weumitute & death is needed.


(3) Medical Exam herDy vestigate and certify to all deaths supposably due to injury A th not only deaths caused directly or indirectly by traumatism Onel RO kung septicemia), and by the action of chemical (drugs or poisons) thefin orelectrical 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 foundAN 2'41961 AM


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 import- ant, 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. Children 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.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT


SERVICE NUMBER


HO XNI HOVIII ONILVANI HIJIMA


MIAL XOVI UXAG.


ORM R-302


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


X


PLACE OF DEATH


Essex (County)


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


Danvers


(City or Town making this return)


1


Danvers


( City or Town )


No.Danvers ..... State .... Hospital, .... Hathorne .... St.


§ (If death occurred in a hospital or institution.


give its NAME instead of street and number)


2 FULL NAME


Elizabeth .... Colbert


(.Smith.).


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


7 .... Willis


Avenue


$1


Winthrop, Mass


( If nonresident, give city or town and State)


Length of stay: In place of death. .. years .. 4 8 .months 10 .days. In place of residence .......... years ...... .. months .......... days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


January. 21 ( Month ) (Day)


1961 ..


( Year)


8 SEX


female


9 COLOR


white


10 SINGLE


MARRIED


(write the word)


WIDOWED


or DIVORCED Widowed


4 I HEREBY CERTIFY.


That I attended deceased


from


19 56


to January ..... 21.


19


61


I last saw h .. enlive on


January ...... 21., 19 .... OLdeath is said to


have occurred on the date stated above, at


7:00a .m.


INTERVAL


BETWEEN


ONSET AND


DEATH


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a) Arteriosclerotic ..... Heart .... Disease


years


(b) Due TGeneralized .... Arteriosclerosis


years


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed ?


.. yes


What test confirmed diagnosis ? aut.o.p.sy.


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


PARENTS


(Address)


Hathorne, ... Mass ... Date ... 1/21/


19. 61


Woodlawn .... Cemetery, ..


Everett ..... Mass


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


January 24,


19


61


7 NAME OF


FUNERAL DIRECTOR


Ernest P. Caggiano


ADDRESS


Winthrop Mass.


Received and filed


JAN-3-0 1961-


... 19.


(Registrar of City or Town where deceased resided )


10a If married, widowed, or divorced Benjamin ... Arnold


(Give maiden name of wife in full)


(or) WIFE


of 2 ..


William Colbert


( Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE7.9 ... Years ....


...?... Months .. 5 ..


Davs


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation:


Waitress & Cook-Retired


(Kind of work done during most of working life)


14 Industry


or Business :


15 Social Security No.


024-01-0342A


Lawrence,


16 BIRTHPLACE (City)


(State or country )


Mass:


17 NAME OF


FATHER


George Smith


18 BIRTHPLACE OF


Lawrence,


FATHER (City)


(State or country )


Mass.


19 MAIDEN NAME


OF MOTHER


Mary Hopping


20 BIRTHPLACE OF


Lawrence,


Mass.


MOTHER (City )


(State or country)


Mary E. Sheehan


21


Informant


(Address)


Hathorne, Mass.


A TRUE COP


Daniel J. Toomey


ATTEST :


(Registrar of City or Town where death occurred)


DATE FILED January 25, 19 61


<


May 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


(Signed )


Andrew .... Nichols ... III


M. D.


50M-9-59-926111


Registered No.


( Was deceased a


U. S. War Veteran.


(if so specify WAR,.


NO


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


R


6 3


ROE


JAN 3 01961 AM


SPACE FOR ADDITIONAL INFORMATION


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


-


X


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town)


No.


38 Forrest St


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. 16


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


PHYSICIAN - IMPORTANT


2 FULL NAME


Estelle Bornstein


(First Name)


( Middle Name)


(Last Name)


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


(a) Residence. No.


38. Forrest St ..


St.


Winthrop


( Usual place of abode)


38


Length of stay: In place of death


.years.


months.


.days. In place of residence


.years


38


months.


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


January


23


1961


8 SEX


Female


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Married


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY


That I attended deceased from


cet. 19.470 to


ANI


23


1961


I last saw h& .. L.alive on


Jan .23


19 61, death is said to


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Theodore Bornstein


(Husband's name in full)


If under 24 hours


Hours ..........


... Minutes


13 Usual


Occupation :


Housewife


(Kind of work done during most of working life)


14 Industry


or Business :


At home


15 Social Security No.


Canada


16 BIRTHPLACE (City)


(State or country)


17 NAME OF


FATHER


Jacob Trattenberg


18 BIRTHPLACE OF


FATHER (City)


Lithuania.


(State or country)


19 MAIDEN NAME


Pauline Geffen


OF MOTHER


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Lithuania


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL January 24 .19.61


7 NAME OF


FUNERAL


DIRECTOR


Paul.R. Levine


ADDRESS


470 Harvard St., Brookline


Received and filed


JAN 24 1961


19


( Registrar)


PARENTS


Theodore Bornstein


21


Informant


(Address)


58 Forrest St., Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death


was filed with me


BEFORE the. burial or transit permit was issued:


Ralph E derianne


(Signature of Agent of Board of Health or other)


Jan, 23,1961


(Official Designation) {Date of Issue of Permit)


-{ 0-928145


IM R-301A 1


RUCTIONS FOR IEL CERTIFICATE


giving OF DEATH


S


not enter k than one ne for each (b) and (c)


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


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


Editions contrib- death but not do the terminal ondition given


Cc ::- Chapter 137, tf 1954. requires ncians to print or the cause or is of death on &certificates, and ajer 48, Acts of D requires Physi- nto print or type nunder signature.


(Signed)


Cleartes Liberman


M. D.


Charles Liberman


238. SARDFOR THE SIGNATURE)


(Address)


winthrop.


Date.


1/23 1961


6


Artery Heart Disease


OTHER


SIGNIFICANT


Left Hemiparesis


CONDITIONS


NO


Was autopsy performed?


What test confirmed diagnosis?


Clinical


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


No


Due To


(b)


Hypertensive- Coronary


Due To


(c)


(a)


Coronary Occlusion Acute


10yrs


il yvs.


have occurred on the date stated above, at


4:15 A,m.


INTERVAL


BETWEEN


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


ONSET AND


11 IF STILLBORN, enter that fact here.


DEATH


1 day.


12


62


AGE


Years


Months .....


......


.Days


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


{if so specify WAR) No


( If nonresident, give city or town and State)


Tifereth Israel of


Winthrop


Everett


10


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE.


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


10


(MIN)


GEERK


8


9:6


5 WINTERBBINSS.


RL PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the following rules of practice: - (1) Attending physicians AveDra96h deaths only as those of persons to whom they have given buside tare 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.


...


??...... 1


OFFICE


OF


E


X PLACE OF DEATH


Suffolk


(County)


FASE PETIT


Winthrop


(City or Town)


No. 42 Atlantic Street


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.


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


2 FULL NAME


George J. Clarson


(First Name)


(Middle Name)


(Last Name)


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


(if so specify WAR)


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


42 Atlantic St ...


St.


(If nonresident, give city or town and State)


Length of stay: In place of death.


.. years.


months.


.days. In place of residence.22.


.. years.


months ..........


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


January 24, 1961


DEATH


(Month)


(Day)


(Year)


4 L HEREBY


CERTIFY,


That I attended deceased from


JEn. L.


-


6


Jon.


19


61


I last saw h ....... alive on


Jon


24


19 ........ 7,


death is said to


have occurred on the date stated above, at


7


n.m.


INTERVAL BETWEEN ONSET AND DEATH


[-21-


19/16


13 Usual


Occupation :


Retired


(Kind of work done during most of working life)


14 Industry


or Business :


Electrical .... Contractor


15 Social Security No.


023-14-6873


Brooklyn


16 BIRTHPLACE (City)


(State or country)


New York


17 NAME OF


FATHER


Michael Clarson


18 BIRTHPLACE OF


Ireland


FATHER (City)


(State or country)


19 MAIDEN NAME


OF MOTHER


Mary Ahern


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


21


Harriet M. Clarson


Informant


(Address)


42 Atlantic St., Winthrop


I HEREBY CERTIFY that a satisfactorystandard certificate of death was filed with me BEFORE the burial or transit permit was issued: talthe Mirianm (Signature of Agent of Board of, Health or other) /26/6/


(Official Designation) (Date of Issue of Permit)


V. M.V


INTRUCTIONS FOR IEL CERTIFICATE


giving S OF DEATH d not enter 10: than one ale for each (b) and (c)


istoes not mean nie of dying, heart failure, ni etc. It means lisse, or compli- which caused


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


ulitions contrib- death but not d'o the terminal ondition given e


:- Chapter 137, f 1954. requires 's ians to print or the cause or of death on thcertificates, and Fr 48, Acts of 9, requires Physi- as o print or type minder signature.


PARENTS


Holy Cross Cemetery 6


Malden


Place of Burial or Cremation (City or Town)


DATE OF BURIAL


January 28


.19.61


7 NAME OF


FUNERAL DIRECTOR


Arthur J. O'Maley


ADDRESS Winthrop, Mass.


Received and filed


JAN-26 -1961


19


(Registrar)


8 SEX


Male


9 COLOR


White


10 SINGLE


MARRIED


WIDOWER


or FAVORGESa


10a If married, widow


detM. McDermott


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 75


Years.


Months.


.Days


If under 24 hours


Hours ..


.Minutes


Due To


(b)


Arteriosclerosis


Due To


(c)


Chronic lephritis


OTHER


SIGNIFICANT


Cerebral Hemorrhare


7


-15-


CONDITIONS


Colostomy


195


Was autopsy performed?


What test confirmed diagnosis?


NO


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


G. n. Caplan


(Signed)


A. N. CAPLAN MD


(PRINT OR TYPE SIGNATURE)


M. D


(Address 186 PRINCETON ST. EAST BOSTON


Date 1-24-61


VC


IM R-301A 1


0-928145


Registered No.


(write the word)


(a) Residence. No.


(Usual place of abode)


19 ......


.... ,


to ....


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


Cromia


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE.


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


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 )


Winthrop (City or Town) No. 60. Johnson Avenue


The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Registered No.


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


[(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 VeteranCBL {if so specify WARY


2 FULL NAME


Clarence.A.Martin


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


(a) Residence. No.


60 Johnson Avenue, Winthrop


St.


(If nonresident, give city or town and State)


( ['sual place of abode)


Length of stay: In place of death.


24years ..


. months


.. days In place of residenc 2.4


years.


months .. .


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


January


24.


1961


8 SEX


Male


9 COLOR


White


MARRIED


WIDOWED


or DIVORCED Widowed


4 I HEREBY


CERTIFY,


That I attended deceased from


October 25, 19 60, to January 24,,


19.61


I last saw him alive on January 24,


19.6.1 .... , death is said to


have occurred on the date stated above, at


10 .: 20pm.


(or) WIFE of


(Husband's name in full)


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a) Acutemyocardialinfarction


INTERVAL


BETWEEN


ONSET AND


DEATH


11 IF STILLBORN, enter that fact here.


3 mos


12


80


AGE


Years.


8


Months.


2.0 Days


If under 24 hours


Hours ......


Minutes


Due To


Arteriosclerotic and hyper-


(b)


tensive heart disease


10


years


Due To


(c) Generalized .... arteriosclerosis ...


12


years-


16 BIRTHPLACE (City)


(State or country)


Mass


17 NAME OF


FATHER


Ambrose A. Martin


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Mass.


Boston Marika


19 MAIDEN NAME


OF MOTHER


Annie Beadle


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Mass


Miss Georgia Morgan


60 Johnson Ave. Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Tabel 2. Serious


(Signature of Agent of Board of Health or other)


70.0 Jan 26 1961


(Date of Issue of Permit)


(Official Designation)


(Registrar)


PARENTS


6WinthropCemetery ,Winthrop


Place of Burial or Cremation


City of Town)


DATE OF BURIAL


7 NAME OF Richard C. Kirby, Inc. FUNERAL DIRECTOR ADDRES1Bennington St .E.Boston


Received and filed JAN 26 1961 19


5-59-925686


AI R-301A 1


NIRUCTIONS FOR CERTIFICATE


C


giving SOF DEATH miot enter 0 than one u for each a (b) and (c)


Does not mean me of dying, a heart failure, tu etc. It means isise, or compli- which caused


dions, if any, chgave rise to ve cause (a), in the under- ' cause last.


mitions contrib- t.death but not the terminal e ondition given


Chapter 137, of 954. requires cins to print or e cause or $ of death on ctificates, and Ce, 48, Acts of quires Physi- t print or type uler signature.


(Signed)


M. Tauxi Kein


M. D.


M. Traunstein, Jr., M/D.


(PRINT OR TYPE SIGNATURE)


(Address)


... 7.3 .... Bartlett .... Rd.WinDate ..... Jan .. 25, ... 19.61.


13 Usual


Occupa


Boston Harbor Pilot Retired


(Kind of work done during most of working life)


14 Industry


or Business :


Pilot Boats


15 Social Security No. .


CBL


East ... Boston


OTHER


SIGNIFICANT


CONDITIONS


none.


Was autopsy performed ?


no


What test confirmed diagnosis ? ... Clinical ... and. .. Lab.


5 Was disease or injury in any way related to occupation of deceased ? no ... If so, specify


January 27th


61


19


21 Informant (Address)


Boston celeru


V.D. V


10 SINGLE


(write the word)


(Month)


(Day)


(Year)


10a If married, widowed,or divorced


HUSBAND of


Alice Dixon


(Give maiden name of wife in full)


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


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)


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. 19


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


PHYSICIAN - IMPORTANT


2 FULL NAME


Mary .... Jane Culkeen


(Sheerin)


[(Was deceased a


{U. S. War Veteran,


{if so specify WAR)


(If deceased is a married, widowed or divorced woman, give also maiden name.) 210 Main St.,




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