Town of Winthrop : Record of Deaths 1961, Part 44

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 44


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).


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Italy


19 MAIDEN NAME


OF MOTHER


Adelina Defilippo


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


21


Giovannina Marasca (wife)


Informant


302 Maverick St., East Boston


I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued: Taltele El ercause (Signature of Agent of Board of Health of other)


11/6/61


(Date of Issue of Permit)


(Official Designation)


C-


1


Registered No.


Alfred


Marasca


2 FULL NAME


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


Boston 42-7-61


PARENTS


3YRS


(Kind of work done during most of working life)


2 DAYS


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


.


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


NOV -01961 111 ...


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 bad 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)


CONSE PITIT


Winthrop (City or Town)


No.


58 Harbor View Ave.


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)


2 FULL NAME


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


58 Harbor View Ave.


St.


(If nonresident, give city or town and State)


Length of stay: In place of death


40


.. years.


months.


......


.days. In place of residence .O.


years


.. months.


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


November 4


(Day)


(Year)


1961


8 SEX


Female


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCER idow


4 I


HEREBY CERTIFY, That I attended deceased from


19 ..**


to.


19 .....


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Clement Wood


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


Years


12


AGE.70


6


Months.


11 Days


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.


16 BIRTHPLACE (cipston


(State or country)


Mass.


17 NAME OF


FATHER


William J Anderson


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Louise


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


England


21 Dorothy Herdt Informant (Address) 3 Cottage Ave. Winthrop, Mass.


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


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


11/6/61


(Official Designation)


(Date of Issue of Permit)


M-4-59-926662


R-301A 1


S UCTIONS FOR A CERTIFICATE Agiving EOF DEATH


d bt enter e than one u for each b) and (c)


es not mean of dying, Ificart failure, aetc. It means s&:, or compli- hich caused


lins, if any, Five rise to e ause (a), nethe under- Cause last.


onions contrib- to eath but not the terminal dition given IC


: hapter 137, f i t 54. requires to print or cause or death on conficates, and er 8, Acts of retires Physi- o int or type de signature.


6


Winthrop'


Winthrop


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


8


19


Nov.


61


7 NAME OF


FUNERAL DIRECTOR


Howard S Reynolds


ADDRESS


Winthrop Mass


Received and filed


November 6.


. 19 67


(Registrar)


PARENTS


sudden


Due


Arterio-sclerotic Heart Disease


(c) .....


10 yrs


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed ?


no


What test confirmed diagnosis? post-mortem judgement


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


M. D).


(Signed)


arthur C. Murray


Arthur C. Murray


(PRINT OR TYPE SIGNATURE)


(A) Winthrop Board of Healthe 5 Nov


19 61


INTERVAL BETWEEN ONSET AND DEATH


Presumably


(b)


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


Natural Causes


(a)


(Month)


Frances J (Anderson) Wood


Registered No.


PHYSICIAN - IMPORTANT [(Was deceased a U. S. War Veteran, (if so specify WAR)


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


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


19 ............ , death is said to


have occurred on the date stated above, at


/٥ p.m.


Coronary Occlusion


010-10-8529


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


TOU


DATE OF DISCHARGE


RANK, RATING


Ci


00


ORGANIZATION AND OUTFIT


6


SERVICE NUMBER


NOV -61961 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 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.


R-301A -


1


TI CTIONS IR L ERTIFICATE


living F DEATH n: enter elan one eor each . ) and (c)


di: not mean &of dying, art failure, c. It means 1 or compli- sich caused


IN, if any, De rise to use (a), ke under- lise last.


dions contrib- tith but not to he terminal co ition given


- lapter 137, 144. requires anto print or he cause or death on O epicates, and · . Acts of gres Physi- Int or type nd signature.


-6)-92 5686


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town)


No. Winthrop Community Hospital


The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


Registered No.


226


§(If death occurred in a hospital or institution, St. } give its NAME instead of street and numher)


PHYSICIAN - IMPORTANT


[(Was deceased a


U. S. War Veteran,


{if so specify WAR)


2 FULL NAME Mrs. Elizabeth VanBuskirk (Tower)


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


(a) Residence. No.


50 Hutchinson St.


(Usual place of abode)


St.


20


(If nonresident, give city or town and State)


Length of stay: In place of death .. . .. years.


months


3


.days. In place of residence.


.years.


.. months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


NOVEMBER 5


1961


(Year)


8 SEX


Female


9 COLOR


T.h.ite


10 SINGLE


(write the word)


MARRIED


WIDOWED Widow


or DIVORCED


4 I HEREBY CERTIFY,


Nov


2


1961


.. , to.


Nov 5


That I attended deceased from


19.61


I last saw h .......


.. alive on


Nov 4


1961, death is said to


have occurred on the date stated above, at


6:10 Am


INTERVAL


BETWEEN


ONSET AND


DEATH


5 DAYS


5 DAYS


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


No


What test confirmed diagnosis ?


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


(Signed)


Dorothy Chaney appleton


M. D.


DOROTHY Cheney VAPPLETON


(PRINT OR TYPE SIGNATURE)


Date. Nov 5 19.6%


6


.T'inthron.


Place of Burial or Cremation


DATE OF BURIAL


linthrop


(City or Town)


Nov. 8


6.1


19


7 NAME OF


FUNERAL DIRECTOR


Howard S Reynolds


ADDRESS


... Winthrop.


Received and filed 19


(Registrar)


10a If married, widowed, or divorced HUSBAND of


Albert


(Give maiden name of wife in full)


VanDushirK


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


~2


4


AGE


Years.


Months.


Days


If under 24 hours


Hours.


.Minutes


13 Usual


Occupation :


(Kind of work done during most of working life)


14 Industry


or Business :


021-01-0743


16 BIRTHPLACE (City)


(State or country ) New Brunswick


17 NAME OF


FATHER


John Tower


18 BIRTHPLACE OF


FATHER (City)


(State or country) New Brunswick


19 MAIDEN NAME


OF MOTHER


Eliza Kelly


20 BIRTHPLACE OF MOTHER (City) (State or country) New Brunswick


21 Informant Aubert C VanBuskirk (Address) 20 Beacon St. Winthrop, Lass


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)


11/6/61


(Official Designation)


(Date of Issue of Permit)


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a)


ACUTE BRONCHO PNEUMONIA


Due To


VIRUS INFECTION


(b)


l'ouselife


At home


15 Social Security No.


Loncton


PARENTS


(Address) 197 Woodside BUG WINTHROP, MASS


(Month)


(Day)


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


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


-


DATE OF DISCHARGE


RANK, RATING


0


ORGANIZATION AND OUTFIT


SERVICE NUMBER


NOV - G.1961 FM


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 of Town)AT HOME 66 Winthrop Shore Drive


Thr Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


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


Registered No.


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


PHYSICIAN - IMPORTANT [(Was deceased a U. S. War Veteran, lif so specify WAR)


2 FULL NAME


Marietta (White) Hoore


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


(a) Residence. No.


(L'sual place of abode)


66 Winthrop Shore Drive


St.


(If nonresident, give city or town and State)


Length of stay: In place of death


5


years.


months


days. In place of residence.


7.2 .. years.


months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWED, ..


or DIVORCEAdDW


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Edwin L Moore


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


93


11


12


AGE


Years.


......


Months ...


2


Days


If under 24 hours


Hours ....


Minutes


13 Usual


Occupation :


None 1211:11.


(Kind of work done during most of working life)


14 Industry


or Business :


At home


15 Social Security No.


None


16 BIRTHPLACE (City)


(State or country)


hass


17 NAME OF


FATHER


Charles H White


18 BIRTHPLACE OF


Ashbørnham


FATHER (City)


(State or country)


Mass


19 MAIDEN NAME


OF MOTHER


Florence H


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Lass


Ashburnham


21 O.A.A. Recards


Informant


(Address)


Winthrop, Lass


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


latte,


(Signature of Agent of Board of Health or other) 11.20, 61


(Official Designation) (Date of Issue of Permit) ,


PARENTS


(Signed)


Mycon b. King


M. D.


MYRUN N.KING M.D.


(PRINT OR TYPE SIGNATURE)


(Address) 22 LI KENSANT ST WINitthe Date.


11/18 1061


6


inthrop


Winthrop


Place of Burial or Cremation


Nov.


(City or Town)


1351


7 NAME OF


FUNERAL, DIRECTOR


Howard S Reynolds


ADDRESS


winthrop Mass


Received and filed NOV 20-1961 19.


(Registrar)


INTERVAL


BETWEEN


ONSET AND


DEATH


7 Days.


Due


GENERAL ARTERIOSCLEROSIS AND


(b)


ARTERIOSCLERCTIO HEART DISEASE


6 YRS.


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


NONE


Nov


18


1961


(Year)


(Month)


(Day)


161


4 I HEREBY CERTIFY, That I attended deceased from


OCT.


19:55


to ...


Nov


18


I last saw he Ralive on


11/16


1961


death is said to


have occurred on the date stated above, at


740 Am.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


CEREBRAL VASCULAR ACCIDENT


(a)


YR-301A 1


TICTIONS İR L ERTIFICATE


ving


F DEATH enter elan one for each ) and (c)


not mean de of dying, art failure, r. It means IS or compli- ach caused


io, if any, f'e rise to Mise (a), je under- gtse last.


duns contrib- dth but not of'te terminal coition given


- apter 137, 191. requires aato print or he cause or of death on rt cates, and 4. Acts of qs'es Physi- pnt or type designature.


-6 -925686


Ashburnham


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


DATE OF BURIAL


No.


3 DATE OF


DEATH


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.


NOV 2 01961 AM


X PLACE OF DEATH


Suffolk (County)


CENS


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.


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


Dr. George H. Schwartz


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


(a) Residence. No.


5 Edge Hill Rd.


St.


Winthrop


(If nonresident, give city or town and State)


Length of stay: In place of death2.O.


.years.


... months.


.days. In place of residence.


years.


months.


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Male


9 COLOR


White


10 SINGLE


(write the word)


3 DATE OF


DEATH


November 18


1961


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY , That I attended deceased from


19 ............ , to ..


19


-19.


......... , death is said to


have occurred on the date stated above, at


10:30 Am.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


Natural Causes


(a)


INTERVAL


BETWEEN


ONSET AND


DEATH


11 IF STILLBORN, enter that fact here.


12


AGE


69 Years.


Months .....


Days


If under 24 hours


Hours.


.......


Minutes


13 Usual


Occupation :


Physician


(Kind of work done during most of working life)


14 Industry


or Business:


Medicine


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Benjamin M. Schwartz


17 NAME OF


FATHER


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Russia


19 MAIDEN NAME


Annie Baron


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


Russia


21 Mrs. Ida Miller


Informant


(Address)


28 Converse Ave .. Newton


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


(Signature of Agent of Board of Health or other)


20,-


(Official Designation)


(Date of Issue of Permit)


Y


S UCTIONS FOR A CERTIFICATE


higiving EOF DEATH


at enter than one for each ) b) and (c)


es not mean of dying, Is teart failure, atc. It means ser, or compli- Which caused


it's, if any, Hive rise to ause (a), nghe under- Hause last.


onions contrib- to eath but not # the terminal edition given


: hapter 137, f 54. requires to print or t cause or death on ce ficates, and ers, Acts of retires Physi- to int or type une - signature.


7 NAME OF


FUNERAL DIRECTOR


Paul ... R ........ Levine


ADDRESS 470 Harvard St., Brookline


Received and filed


November 20, . 1961


John a. Clave


PARENTS


(Signe


Arthur (O. Murray,


I. D.


OF MOTHER


Arthur C. Murray (PRINT OR TYPE SIGNATURE), Winthrop Board of Health


18 Nov 1961


6


Ohel Jacob


Woburn


(City or Town)


Place of Burial or Cremation


DATE OF BURIAL


November


20


61


-


Was autopsy performed?


NO


What test confirmed diagnosis? post-mortem judgement


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


sudden


Due To


(c)


OTHER


SIGNIFICANT


CONDITIONS


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


MARRIED


WIDOWED Single


or DIVORCED


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


(Usual place of abode)


20


U. S. War Veteran,


(if so specify WAR)


WW I


PHYSICIAN - IMPORTANT


(Was deceased a


2 FULL NAME


Registered No.


No. 5 Edge Hill Rd


₹: R-301A 1


M-9-59-926662


Due


(b)


Presumably Coronary Occlusion


Boston


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE 53/18


DATE OF DISCHARGE


577-19


RANK, RATING


IST LT


ORGANIZATION AND OUTFIT


Medical CAPS


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.


NOV 2 01901 18


R-301A 1


TICTIONS JR L ERTIFICATE


living F DEATH n enter e lan one eor each ) and (c)


& not mean di of dying, art failure, c. It means as or compli- sich caused


tier, if any, L'e rise to use (a), ge under- Wise last.


dims contrib- Rith but not to he terminal co ition given


apter 137, M1. requires anto print or he cause or death on emlicates, and . Acts of eq'res Physi- Int or type nd signature.


1-62-925686


PLACE OF DEATH


Suffolk. (County )


Winthrop


(City or Town)




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