Town of Winthrop : Record of Deaths 1961, Part 40

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 40


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


X


PLACE OF DEATH


Suffolk (County)


ISN'T


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.


201


Winthrop Community Hospital


f(If death occurred in a hospital or institution,


St. ¿ give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME Annetto


( DeLuca)


Stasio


(Last Name)


(if so specify WAR)


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


(a) Residence. No.


149 Somerset Avo.


.St.


Winthrop Mass ..


(If nonresident, give city or town and State)


Length of stay: In place of death. .years. months. 1 .days. In place of residence. 12


years


months ..


.....


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


female


9 COLOR


white


10 SINGLE


MARRIED


(write the word)


DEATH


(Month)


(Day)


(Year)


4 I HEREBY


CERTIFY, That I attended deceased from


APRIL 10


19


5€


to.


CCT 13


196


I last saw h ERalive on


DC+ 13


1961


.,


death is said to


have occurred on the date stated above, at


8°- P


m.


INTERVAL BETWEEN ONSET AND DEATH


INFARCTION.


Due To


CEREBRAL HEMORRHAGE


(b)


ARTERIO SCLERITIC + HYPERTENSIVE


Due To


(c)


HEART DISEASE È AURICULAR


FIBRILLATION


2 mo.


OTHER


"LEFT HEMIPLEGIA FROM


SIGNIFICANT


CONDITIONS


PREVIOUS CEREBRAL


2 mg


Was autopsy performed?


N'a


What test confirmed diagnosis?


IKS. + CLINICAL


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


(Signed)


M. D


MYRON IN. KING M.D.


(PRINT OR TYPE SIGNATURE)


(Address) 222 PLEASANT ST


WINTHROP.


Date.


10/13


061


6


Winthrop.Cemetery ...... Winthrop


(City or Town)


Place of Burial or Cremation


Oct. 16,


61


DATE OF BURIAL


19


7 NAME OF


FUNERAL DIRECTOR


Ernest P. Caggiano


ADDRESS


147 Winthrop St. Winthrop


Received and filed


OCT 16 1961


19.


(Registrar)


PARENTS


17 NAME OF


FATHER


Joseph DeLuca


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Philomena Sarni


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


21


Informant


Arthur Stasio


(Address) 149 Somerset Ave, Winthrop


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


(Signature of Agent of Board of Health or other) Materi Ningen


10/16/61


(Official Designation)


(Date of Issue of Permit)


7 :B.


UCTIONS OR CERTIFICATE


iving OF DEATH t enter han one for each b) and (c)


s not mean of dying, eart failure, c. It means . or compli- sich caused


s, if any, ve rise to zuse (a), he under- use last.


ons contrib- ath but not the terminal dition given


FRICAL EXAMINER


Chapter 137, 954. requires is to print or cause


or death on tificates, and 48, Acts of uires Physi- print or type er signature.


R-301A 1


JURISDICTION


NOTIFIED & DECLINED


3 DATE OF


OCT


13


1961


WIDOWEDmarried or DIVORCED


10a If married, widowed, or divorced HUSBAND of


Arthur


(Give maiden name of wife in full)


Stasio


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


60


If under 24 hours


12


AGE.


Years.


Months .....


Days


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.


16 BIRTHPLACE (City) (State or country) Italy


No.


[ (Was deceased a


U. S. War Veteran,


(First Name)


( Middle Name)


(Usual place of abode)


(or) WIFE of


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


ANTERO-LATERAL MYOCARDIAL


(a)


28145


.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE.


RANK, RATING


0


TROP


ORGANIZATION AND OUTFIT


SERVICE NUMBER.


OCT .. J.G.1961.AH


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 ( punty,


Winthrop (City or Town)


No. 8.76 Shirley ..... St.


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.


202


f(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,


no


lif so specify WAR)


(a) Residence No. 876 Shirley St. (I sual place of abode )


St


( It 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


OCT


18


1961


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


That I attended deceased from


19


19 ... , to


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


19


death is said to


have occurred on the date stated above, at


5:10 Pm.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


INTERVAL BETWEEN ONSET AND DEATH


(a)


Death was due to


Due


natural causes


(b)


presumably coronary


Due (c)


Toocclusion acute que


OTHER O Coronary ARTERY SIGNIFICANT CONDITIONS Heart Disease,


Was autopsy performed Charles Liberwan My What we confirmed dipep throp Board of Health


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


(Sigpad); Clearles LebenMaria, M. D. CHARLES LIBERMAN (PRINT OR TYPE SIGNATURE)


(Address) Winthrop Man Date. 10/19/1961


6


Winthron


Winthrop


Place of Burial or Cremation


DATE OF BURIAL


Oct 21 (City or Town) 61


19


7 NAME OF


FUNERAL DIRECTOR


Frederick J. Magrath


ADDRESS East Foston


Received and filed OCT.19 1961 19


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


male


9 COLOR


white


10 SINGLE


(write the word)


MARRIED


WIDOWEmarried


or DIVORCED


10a If married, widowed, or divorce


E.


Cahill


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


61


If under 24 hours


AGE


Years ...


„Months.


.Days


supervisor


13 Usual


Occupation :


(Kind of work done during most of working life)


14 Industry


or Business:


N. E. Tel & Tel. Co.


15 Social Security No.


011-05-0207


16 BIRTHPLACE (City)


(State or country)


East roston, Nass.


17 NAME OF


FATHER


Henry Hill


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ma.s.s.


19 MAIDEN NAME


' Catherine Hanrahan


OF MOTHER


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


East Foston


Mass.


21


Informant


(Address)


876 Shirley St. Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE /the burial or transit permit was issued:


(Signature of Agent of Board of Health or other) Health Afiex


10/19/11


(Official Designation)


(Date of Issue of Permit)


1.1. V.B.


R-301A 1


UCTIONS OR CERTIFICATE


giving OF DEATH ot enter than one for each b) and (c)


s not mean of dying, eart failure, tc. It means or compli- hich caused


s, if any, ve rise to use (a), he under- use last.


Fons contrib- ath but not the terminal dition given


hapter 137, 54. requires to print or cause or death on ificates, and B, Acts of ires Physi- int or type · signature.


0 9-925686


PARENTS


Mary E. Hill


East Foston


.. Hours ..... .. Minutes


2 FULL NAME


Frederick J. Hill


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


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


TOM 11


LI


. fi.


ERST


6.


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 rece.it 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 pur uits 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.


OCT 1 91961 PM


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.


Winthrop Convalescent Home. No.


[(If death occurred in a hospital or institution,


St. } give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME


Elvira Frattaroli


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


lif so specify WAR)


(a) Residence. No.


521 Bennington St.


St.


EastFoston


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay : In place of death .


. ...


years 2 months 24 days. In place of residence


5


years.


months ..


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


Oct. 19 -1961


DEATH


(Month)


(Day)


(Year)


1961


4 I HEREBY CERTIFY


,That I attended deceased from


July 28


1961


Oct. 19


to ...


I last saw he Yalive on


Oct 18


1961


death is said to


have occurred on the date stated above, at


30


m.


INTERVAL


BETWEEN


ONSET AND


DEATH


7 months AGE


(or) WIFE of


Joseph Frattaroli


(Husband's name in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) .... Carcinoma of uterine cervix


Due To (b)


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed ?


What test confirmed diagnosis ? Laboratory Biopsy


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


(Signed)


Chaney Milano


M. D.


CHARLES MELONI (PRINT OR TYPE SIGNATURE)


(Address) 305 Harre tt 219 rtm Date. Oct 19-186 /


6 Holy Cross


Nalden


Place of Burial or Cremation


Oct.


21


(City or Town) 61 19


7 NAME OF


FUNERAL DIRECTOR


Frederick J. Magrath


East Foston


ADDRESS


Received and filed 19


(Registrar)


PARENTS


17 NAME OF


FATHER


Antonio Diracco


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Palma Granali


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


Olga Tango


21


Informant


(Address)


Neptune Rd. E. oston


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: 60 Percauur 1


(Signature of Agent of Board of Health or other)


10/20161


(Official Designation)


(Date of Issue of Permit)


X


UCTIONS OR CERTIFICATE


giving OF DEATH t enter .han one for each b) and (c)


ès nat mean of dying, eart failure, tc. It means , or campli- hich caused


is, if any, ve rise ta use (a), he under- luse last.


ians cantrib- ath but nat the terminal ditian given


hapter 137, 54. requires to print or cause or death on ficates, and 8, Acts of tires Physi- int or type ir signature.


59-925686


1


203


Registered No.


10 SINGLE


(write the word)


MARRIED).


WIDOWED dowed


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


11 IF STILI.BORN, enter that fact here.


12


62Years.


......... Months ............ Days


If under 24 hours


Hours.


Minutes


13 L'sual


Occupation :


housework


(Kind of work done during most of working life)


14 Industry


or Business :


own home


15 Social Security No.


C. N. B. L.


16 BIRTHPLACE (City)


(State or country)


Italy


8 SEX


female


9 COLOR


white


f(Was deceased a


{U. S. War Veteran,


no


R-301M -26-


in


-


DATE OF BURIAL


POSTEre 17-6-11


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


OF TOTVA


7% . .......


10


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observ 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 if ho2 01961 AM persons who, though disabled by recognized disease unrelated to my forin 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.


OFRICE


CLERK


6 5


MASS.


WINTER


R-305


1


Middlesex (County) Medford


(City or Town)


The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH


Medford (City or town making return)


Registered No.


204


2 FULL NAME Martha E. Malone


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


[if so specify WAR)


no


(a) Residence. No. 7.77 Shirley


St.


winthrop


(If nonresident, give cfty or town and State)


Length of stay: In place of death. ...... .... years ..... months. 1 days. In place of residence. 10 years .. months. ... days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


October 23 1961


(Month) (Day) (Year)


9 SEX


female


10 COLOR


white


11 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


widowed


4I 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.)


lla If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


James H. Malone


(or) WIFE of


(Husband's name in full)


Cerebral Hemorrhage


5 Accident, suicide, or homicide (specify)


Date and hour of injury 19


If accidental, was injury causally related to the death ?


(Kind of work done during most of working life)


15 Industry


or Business :


Retired


16 Social Security No.


Chelsea


17 BIRTHPLACE (City)


(State or country)


Mass.


18 NAME OF


FATHER


Patrick B. Kiernan


19 BIRTHPLACE OF


Boston


FATHER (City)


(State or country)


Mass.


20 MAIDEN NAME


Catherine Kiernan


OF MOTHER


21 BIRTHPLACE OF


Boston


MOTHER (City)


(State or country)


Mass.


22


Bertha R. Kiernan


Informant


(Address)


777 Shirley St., Winthrop


ATTEST:


Flugh7 Lyons)


(Registraf b &o wher


Mere death occurred)


DATE FILED


Oat 25, 2661


19


Gify ... Glet


V.B.V


.


the time of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


25M-4-59-925100


(Address)


Medford, Mass.


Date.


Oct 37, 67


7 Holy Cross


Malden


Place of Burial, or Cremation.


(City or Town)


DATE OF BURIAL Oct 26, 1961 19


8 NAME OF FUNERAL DIRECTOR M.c.Glinchey Funeral


ADDRESS 383 Broadway Chelsea


Received and filed 19


(Registrar of City or Town where deceased resided)


12 IF STILLBORN, enter that fact here.


13


AGE.


71


Years.


Months ...


Days


Hours.


.Minutes


14 Usual


Occupation :


School Teacher


Where did Injury occur ? (City or town and State)


Did injury occur in or about home, on farm, in industrial place, or in public place ?


Manner of


(Specify type of place)


Injury


(How did injury occur ?)


Nature of


Injury


While at work ?


Was autopsy performed?


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


(Signed)


Andrew D.


.Guthrie


M.


10


PLACE OF DEATH


No.


Lawrence Mem. Hospital


(If death occurred in a hospital or institution,


St. } give its NAME instead of street and number)


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


(Usual place of abode)


PERSONAL AND STATISTICAL PARTICULARS


If under 24 hours


PARENTS


HOYTRUE COPY.


RECEIVED


OF TOWN


11.12 1


MIN


WIN


6


ROP MASS


SPACE FOR ADDITIONAL INFORMATION


OCT 3.01961 AM:


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT


SERVICE NUMBER


C


PLACE OF DEATH


Suffolk (County)


"'inthron


(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.


205


Registered No.


[(If death occurred in a hospital or institution,


St. ¿ give its NAME instead of street and number)


2 FULL NAME


(First Name)


(Middle Name)


(Last Name) (if so specify WAR)


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


(a) Residence. No.


(Usual place of abode)


Length of stay :


In place of death.


years ..


.months


8


days. In place of residence. years .. months ......... ... days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


October


24,


1961


(Month)


(Day)


(Year)


4 I HEREBY


CERTIFY,


That I attended deceased from


61


I last saw Her.alive on


October .... 23,


19 .. 61 .. , death is said to


have occurred on the date stated above, at


1:50 a.


.. m.


INTERVAL


BETWEEN


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


Massive cerebral hemorrhage with


right hemiplegia


Due To


(b)


Generalized arteriosclerosis


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed?


no


What test confirmed diagnosis? Clinical & laboratory


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


(Signed)


M. Traunsteinf.


(PRINT OR TYPE SIGNATURE) (


(Address)


73. Bartlett Rd.


Winthrop 52, Mass.


Date Oct. 24, 19 61


6 Winthrop


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


Oct. 26 19.61


7 NAME OF


FUNERAL


DIRECTOR


Howard S Reynolds


Winthrop, Mass


ADDRESS


Received and filed


OUT 05 1961


19


( Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR


White


10 SINGLE


(write the word)


MARRIEDidow


WIDOWEDLO


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


Walter


(Give maiden name of wife in full)


Bliss


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


8 days


AGE


Years ..


.. Months.


15


If under 24 hours


12


70


11


Days


Hours.


.........


Minutes


13 Usual


Occupation :


Clerk


(Kind of work done during most of working life)


14 Industry


or Business:


Hospital record room


15 Social Security No.


034-20-9501


16 BIRTHPLACE (City) (State or country) MESS.


17 NAME OF


FATHER


Robert Brighty


18 BIRTHPLACE OF


FATHER (City)


M. D


(State or country)


England


19 MAIDEN NAME


OF MOTHER


Eliza Porter


20 BIRTHPLACE OF MOTHER (City) (State or country) England


21


.Priscilla Colarusso


Informant


(Address)


5 Pearl Ave, Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: 261 1


(Signature of Agent of Board of Health or other)


1 =1× 9 /6/


(Official Designation)


(Date of Issue of Permit)


V.B.


/


28145


R-301A 1


CTIONS OR ERTIFICATE


iving F DEATH enter an one or each ) and (c)


s not mean of dying, art failure, c. It means or compli- ich caused


s, if any, ve rise to use (a), he under- use last.


ons contrib- ath but not he terminal lition given


Chapter 137, 954. requires s to print or cause or f death on ificates, and 48, Acts of uires Physi- rint or type er signature.


Bertha


(Brighty)


Fliss


[ (Was deceased a


U. S. War Veteran,


12 Girdlestone P.d.


St


35


(If nonresident, give city or town and State)


Feb. 17,


59


to ...


Oct. 24,


19


ONSET AND


DEATH


2 yrs.


Northbridge


PARENTS


Traunstein, Jr., M. D


Winthrop


PHYSICIAN - IMPORTANT


No. inthron Community 03.1001 4


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE. RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


RECEIVED


TOWA


OF


(MIN


BILERK


C


6


35


INTHROR


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.


OCT 2 51961 PM 1 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.




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