Town of Winthrop : Record of Deaths 1961, Part 46

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 46


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


6 CE ,


RULES OF PRACTICE DEC 1 1961 AM


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.


2


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.


IM R-301A 1


PLACE OF DEATH


Suffolk (County)


Boston (City or Town)


JOSEPH D WARD SECRETARY OF TH" ".MON WEALTH DANISION OF VI IL. STATISTIC:


STANDARD


CERTIFICATE OF DEATH


Registered No.


{ {If death occurred in a hospital or institution, St. I give its NAME instead of street and number) PHYSICIAN - IMPORTANT [ (Was deceased d YU :. S. War Veteran. (if to specify WAR)


2 FULL NAME Joseph P FLANERY, Si. ( First Name) ( Mlichlic Name) ( Last Name) (If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence No. 25. Taylor


Winthrop, Mass.


(If nonresident, que city of town and State)


length of stay :


In place of death


years.


months


8


.. days.


In place of residence


45 year


months .. ..


days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


1310


9 COLOR


White


10 SINGLE


MARRIED


WIDOWEDTidowed


or HIVORCED


:Oa If married, widowed, or divorced


HUSBAND of .


Margaret McDonald


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AGE 64 Years.


6 ..... Months ..


.29 ... Days


If under 24 hours


.Hours ..........


... Minutes


:3 Ustra!


Occupation :


Chauffeur (Retired)


(Kind of work done during most of working hie)


14 Industry


or Business :


Boston Sand & Gravel Corp


15 Social Security No.


010-22-8548


16 BIRTHPLACE (City)


(State or country)


Latertarm


17 NAME OF


FATHER


Owen W. Flannery


18 BIRTIIPLACE OF


FATHER (City)


(S:ate or country)


Ireland


19 MAIDEN NAME


OF MOTHER


Margaret Perron-


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Ireland


21 Veterans Administration Records


Intormant


(Address)150 S. Huntington A-3 Boston Moss. I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: namaratil


Signature of Agent of Board of Health or other> 4034 10/16/61


(Official Designation)


(Date of Issue of Permit)


1 VR


ITRUCTIONS FOR IL CERTIFICATE


1 giving £ OF DEATH I not enter : than one te for each 1 (b) and (e)


idoes not mean ide of dying. heat fui.ure. l' etc. It means isse, or compli- Wwhich caused


ions, ij cny,


cause (a). the under. cause last.


ditions contrib- death but not to the terminal condition given


Cha' ler 137, f 1954. requires lars lo prin: : the world of death on erlsficates. and 1.r 48, Acts of require l'ha si - e primi or aspe nurt signature


1.


7 NAME OF


C.


FUNERAL. DIRECTOR


Q Malloy Fureral Hora


ADDRESS 79 Atlantic St ... Winthrop, Loss.


Received And filed


OCT 17 1961


.. 19


........ 1 1-


(Reg.strar)


PARENTS


( Address) VAH Boston, Lasse Date Oct. IL 19.61


6


MAnthrop Cemetery


Winthrop


Place of Burial or Cremation (City or Town)


DATE OF BURIAL October 17 61


19.


I .. TE.VAL


DETWEEN


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


Hepatic failure 7 days with


( a)


cirrhosis ( Themachromatosis ) .


ONSET AND DEATH Tours


Due l'v


Due To (c)


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


Yes


What test confirmed diagnosis? '"tony & clinica]


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


(Signed)


HENRY T. OKNA (PRINT OR TYPE SIGNATURE,


---


To be filed for buria! permit with Board of Health cris Mient


No. Veterans Administration Hospital


.


( L'sual place of abode )


3 DATE OF


DEATII


Octcher


(Month)


(Day)


(Year)


4I HEREBY CERTIFY.


Oct ... 6


19


61, to.


October 11


That i attended deceased from


XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX, death is said tol have occurred on the date stated above, at 11:25 .... A.m.


(write the word)


Ferrins


00-928145


A TRUE COPY ATTEST: Charles In. Takie Oty Registrar


TOM


OF


11 12.1


CLERK


6


JAN 2 1962 AM


IM R-301A 1


STRUCTIONS FOR AL CERTIFICATE


in giving E OF DEATH not enter "e than one se for cach , (b) and (c)


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


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


ditions contrib. death but not to the terminal condition given


45


: :- Chapter 137. of 1954. requires :ians to print or the cause or of death on certificates, and e: 48, Acts of requires Physi- to print or type under signature. n.C. Directon use only


CK Ink.


1


PLACE OF DEATH


SUFFOLK


(County)


BOSTON


(City " Town)


Thr Commmmmmwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD


235


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


Registered No. 10056


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


2 FULL NAME .


Rose Corwin


(First Name)


(Middle Name)


(Last Name)


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


36 Perkins Street


Winthrop, Massach setts


(if nonresident, give city or town and State)


Length of stay:


fn place of death ......


years ..


..


months ...... .... d! 1


In place of residence +0


.years.


months ....


days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


October 23, 1961


DEATH


(Month)


(Day)


(Year)


4I HEREBY CERTIF


That > attended deceased from


19 ...


October 23


. 19.


61


October 23,


to ..


we last saw HO.Lalive on


October 23, 1961, death is said to


have occurred on the date stated above, at


8:05 pm.


DEATH WAS CAUSED BY: IMMEDIATE CAUCE


(a) rupture of abd. aneurysm


....


ONISET AND


CZATH


1


hr.


1)1 To


(b)


atherosclerotic abd costic


Due To


aneurysm


(d) atherosclerosis, severe.


OTHER


SIGNIFICANT


generalized.


CONDITIONS


hypertensive heart di


8


Was autopsy performed?


Y.O.S


What test confirmed diagnosis?


.. Autopsy


S Was disease or injury in any way related to occupation of deceased?


If so, specify


(Signed)


M. D


Charles h ... Cl ....... D.


(PRINT OR TYPE SIGNATURE)


(Address) A.s.s't ... DIF ...


Nt. Lebanon, Workmen's Circle, W. Fox 6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


October 25,


19


67


7 NAME OF


FUNERAL DIRECTOR


Arnold Golov


ADDRESS


1668 Beacon St. Brookline


Received and filed OCT 26 1961. --- 19


Charles & Track


"gistrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR


White


(write the word)


10 SINGLE


MARRIED


WIDOWED


or DIVORCEMarried


10a Ii married, widowed, or divorced


HUSBAND of


(Give m .; Jen name of wife in full)


Samuel Corwin


(or) WIFE of


(Husband's name in fuil)


11 IF STILLBORN, enter that fact here.


12


81


Years ..........


.Months.


... Days


If under 24 hours


.Hours .............. Minutes


13 Usual


Housewife


(Kind of work done during most of working life)


14 Industry


or Business :


At Homo


15 Social Security No.


None


16 BIRTHI'LACE (City)


(State or country)


Hungary


17 NAME OF


FATHER


Joseph Ober


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Hungary


19 MAIDEN NAME


OF MOTHER


Celia (CBL)


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Hungary


21 Samuel Corwin


Informant


........


(Address)


So Perkins 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)


:1184


10-25-61


(Date of Issue of Permit)


! (Official Designation)


[ ( Was deceased a U. S. War Veteran. (if so specify WAR) No


(a) Residence. No. ( l'sual place of abode)


CERTIFICATE OF DEATH


Massachusetts General Hospital BAKER MEMORIAL


No.


0-928145


PARENTS


15-yr:


Occupation :


yrs


61


A TRUE COTY ATTEST:


Charles ,. Meskie


RECEIVED


TUK


LERK


إم)


..


THROP.


JAN 2 1962 AM


M R-305 1


7 25M-4-59-925100 as soon as possible after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) 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 Nature of Injury


PLACE OF DEATH


Suffallmy


Chelsea)


No. "Chelsea Naval Hospital


.......


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


[(Was deceased a


U. S. War Veteran, UMI &II.


[if so specify WAR)


(a) Residence. No. 1.770 Cliff Ave. (Usual place of abod


......... Sł. (If hontes the town and State)


Length of stay: In place of death. .years. .......... .months. 15.days. In place of residence ............. years. months 1.5 ..... days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


Oct 24, 1961


(Year)


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.)


Blunt force injury of head with" fracture .... of ....... skul .......... guboura.]


hematomas and cerebral laceration


5 Accident, suicide, or homicide (specify) ...


Accident


Date and hour of injun or about 10/8/61


If accidental, was injury causally related to the death ?


Where did


Injury occur ?


Winthrop Mass


(City or town and State)


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


Manner of


Injury


.......


Accidental fall .... to ... pavement


How did injury occur ? )


While at work ?


... Was autopsy performed?


yes


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


(Signed)


Michael A.Luongo


M. D.


(Address) Boston , Mass. 10/24/61


Place Amlian @ lownationat 1. Cem. it Nyer, Va DATE OF BURIAL 19


8 NAME OF Oct. 30, 1961 FUNERAL DIRECTOR William E.McGin


ADDRESS 167-Maple


Received and filed DEC 1- 101


19


(Registrar of City or Town where deceased resided)


9 SEX


10 COLOR


11 SINGLE


MARRIED


WIDOWED


or DIVORCED,


(write the word)


Single


Tfa ITharried, widowed, of


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


12 IF STILLBORN, enter that fact here.


13


If under 24 hours


AGB3


... Years .....


5


Months .......


.Days


Hours ....


.Minutes


14 Usual


Occupation :


WHOiwork done during most of working life)


15 Industry


or Business :


......


retired


16 Social Security No.


17 BIRTHPLACE (City)


(State or country)


18 NAME OF


FATHER


Haverhill, Mass.


Michael Buckley


19 BIRTHPLACE OF


FATHER (City) (State or country)


20 MAIDEN NAME


Haverhill, Mass.


OF MOTHER


Julia Creene


21 BIRTHPLACE OF


MOTHER (City)


(State or country)


Peabody , Mass.


22 Informant (Address) Mary Buckley


A TRUE COPY.


28 Forost St. Danvers, Muss.


ATTEST:


(Registrar of City of Town where death occurred)


DATE FILED


Oct. 25, 1961


19


236


(City or town making return)


Registered No. 52%


2 FULL NAME (INQuase Pista ma HGKIR Ved or divorced woman, give also maiden name.)


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


Chelsea


SIVILU ULALN LITEWKIIEK KIBBUN -


THIS IS A PERMANENT RECORD


PARENTS


of divorced


6


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DEC.121961 ... AM


DATE OF DISCHARGE RANK, RATING


......


ORGANIZATION AND OUTFIT


SERVICE NUMBER


ORM R-301A


ditians, ifany. ich gave rise to cause lai, ing the under. & cause last


conditions contrib. to death but not to the terminal candition given


Chapte- 13 :. : 1954. Finquire ans to print o. the sause or of death . 1. certificates, and 1 4%. A.Is of eusies Plivel. " print at type nier signature M.C.


12-1000


-11-59-926662


PLACE OF DEATH


Suffolk (County)


JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD


CERTIFICATE OF DEATH


Registered No.


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


I HYSICIAN -- IMPORTANT [(W'a deceased a U. S. War Veteran. no


(if so specify WAR)


St. .Winthrop, Mass.


(If nonresident, give city or town and State)


months.


.. days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


CCT


30


1961


(Month)


(Day)


(Year)


8 SEX


fomale


9 COLOR


white


10 SINGLE


MARRIED


(write the word)


WIDOWED


of DIVORCEDWidowed


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


William Brown


(liusband's name in full)


11 IF STILLBORN, enter that fact here.


12


ACE.


90


Years.


Months ..... ..


Days


if under 24 hours


Hours ..........


Minutes


13 Usual


Occupation :


Housewife


(Kind of work done during most of working life)


14 Industry


of Business :


15 Social Security No. ..... none


16 BIRTHPLACE (City)


(State or country)


Hass.


17 NAME OF


FATHER


Harris Feyser


18 BIRTHPLACE OF


.


FATHIFR (City)


(State or country)


Pcland


19 MAIDEN NAME


OF MOTHER


Caroline "olson


20 BIRTHPLACE OF


MOTIIER (City)


(State or country)


Hass


Boston,


21 Informant Leslie Bro:m.


(Address)


26 Novada St. Winthrop, Mass.


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 y


4250


10/31/6/


(Official Designation)


(Date of Issue of Permit)


237


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


1


Boston (City or Town)


No. . Neponset View Hospital


2 FULL NAME ..


Annie C.Brown


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


(a) Residence. No. 26 Nevada Street,


(Usual place of abode)


Length of stay: In place of death.


3


.years ..


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


PERSONAL AND STATISTICAL PARTICULARS


VIHEREBY CERTIFY, That I attended deceased irom


Aprimary


195%, to CT 20


1961


I last saw herlive on


OCT 30


1961


death is said to


have occurred on the date stated above, at


5:00 P. m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a)


L


€ 1.


Due To (b)


Due To (c)


OTHER SIGNIFICANT CONDITIONS


W'as autopsy performed ?


What test confirmed diagnosis ?


5 W'as disease or injury in any way related to occupation of deceased? ¿... If so, specify


(Signed)


(Address) Novinky


mi Pare 10/30 10c.j


6


David Vicur Choulim (Lebanon) W.Roxbury Piace of Burial or Cremation (City or Town) DATE OF BURIAL November 1, 19 67


7 NAME OF


FUNERAL DIRECTOR ..


Benjamin F Solomon


120 Harvard Stress


Bico-line.


ADDRESS


....


C


19


(Registrar)


T


V.B


INSTRUCTIONS FOR ICAL CERTIFICATE


In giving SE OF DEATH do not enter more than one ause for cach a). (b) and (c)


is does nul meda mode of dying. us heart failure. sid, etc. It means iseuse, or compli- s which caused


1 .. . EU.VAL ELTWEEN CI:SET AND DEATH


-111.21 CM. 1).


(PRINS OR TYPE SIGNATURE)


Che Commonwealth of Massachusetts


PARENTS


Poston


A TNUL CUCK ATTEST: Charles it . I . Kie City Registrar


OF TOW


1: 12


1)


ULERK


6


HROP


JAN 2| 1962 AM


238


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


10500


Registered No.


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


PHYSICIAN - IMPORTANT


[Was deceased a {C. S. War Veteran. lif so specify WAR)


( If deceased is a married, widowed or un ed woman, give als maiden name. )


(a) Kesidence No. 4.55 Shirley


st.


Winthrop, Massachusetts (If nonresident, give ally o- town and State)


30 years.


.. months. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


white


10 SINGLE MARRIED TRAINED or DIVORCED


(write the word)


(Month) (Lay)


4I HEREBY CERTIFY. That _ attended deceased from November 3, 1961, 10+ 02 19 6 Wf last saw ho MMlive on Nor MO- 6, 1961, death is said to have occurred on the date stated above, at 1:35 cm.


DEATH WAS CAUSED BY : IMMEDIATE CAUSE


(a)


Extension of leute


Inferior-Myocardial


(0),


Due To (c) .cuto Inforior Myccardi .. ]


3day.


OTHER


Infarction


SIGNIFICA CONDITIONS COMOMENT ENCOPY CHIC.


W'as autopsy performed?


1.0


What test confirmed diagnosis?


Clinical


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


(Signed)


M. D


Cherles L. Ci ... . D. (PRINT OR TYPE SIGNATURE)


(Address) Asset. Dir., Na s. Com'1. 1.327. Dave .... 1967


Holy Grov 6


Place of Burial or Cremation


DATE OF BURIAL


7 NAME OF


DIRECT


ADDRESS


Recife is the NOV 8 1961 7 .... 19


(City or Town) 1068) 21 Informant (Address),


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


4361


// (Signature of Agent of Board of Health or mber) 11/6/6/


(Official Designation)


(Date of Issue of Permit)


If under 24 hours Hours .. ...... .. Minutes


Occupation :


(Kind of work done aring most of working life)


014 Industry


or Business :


15 Social Security No.


AG BIRTIIPLACE (City) (State or country)


17 NAME OF


FATHER


18 BIRTHPLACE OF FATHER (City) : (State or country)


Germany


19 MAIDEN NAME OF MOTHER


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


Ireland


1-928145


PLACE OF DEATH!


SUFFOLK


(County) COSTON


(City or Town)


JOSEPH D. WARD :"CI ITALY OF THE COMMONWEALTH LIV.SION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


Mcasachusolis Gowww. Mar Stal OUTER MEMORIAL


No.


2 FULL NAME: Mary S. Hanlc. ( First Name)


Name)


(Last Name)


( ['sual place of abode)


Length of stay. In place of drain . years. months .days. in place of residence


3 DATE OF DEATH NOVEMBER 6, 1962


Married


102 If m! rried, widowed, or divorced HUSBAND of


Mr. , (Give maiden name of file in fat)


(or) WIFE of


(Husband's name in full)


11 IF STILLBORN, enter that iact here.


12 - ... Years .... 7 Months ........... .Days


T.


RM R-301A 1


STRUCTIONS FOR AL CERTIFICATE In giving E OF DEATH not enter re than one se for each b. (b) and (c)


does not mean de of dying. heart failure. elc. It means Case, or compli- which caused


ions, if any. gave rise to


the under. cause last.


-ditions contrib- death but not do the terminal condition given


36.1


:. Chapter 137. f 1954. requires ians to print or the cause or of death on ertincates, and r 48, Acts of acquires Physi- To print or type niler si nature w. C. Directon use only K Ink.


PARENTS


TVB


Charles . til


OF TOW


11 12 1


OFF


NII


is


CLERK


6 5


MAS


THROP


JAN 2|1962 AM


X


WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD


(b) 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


PLACE OF DEATH


Essex (County)


Lynn


(City or Town)


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Lynn


(City or Town making this return)


239


94 Franklin Street No. Leonora B. Madden ( Boardman)


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


2 FULL NAME


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


(a) Residence. No ... 86 Plummer Ave.


St.


Winthrop


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death 8 years ...


months.


.days. In place of residence.


8. years


months.


.. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


male


9 COLOR


white


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


widow


4 I HEREBY CERTIFY,


That I attended deceased from


July


19 ..


50,


to


December ...... ]


19 ...


61


I last saw h.e.lalive on


Nov.28/1961 19 ..


...... , death is said to


have occurred on the date stated above, at 6.30 p.m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) Cerebrovascular ..... accident ..


INTERVAL BETWEEN ONSET AND DEATH 4 mo.


11 IF STILLBORN, enter that fact here.


12


AGE.90 ... Years ....


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


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


Housewife


(Kind of work done during most of working life)


14 industry


or Business :


Own home


15 Social Security No ..... none


16 BIRTHPLACE (City)


(State or country)


Manne


OTHER SIGNIFICANT CONDITIONS


Was autopsy performed?


no


What test confirmed diagnosis?


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


(Signed)William Berenson


M. D.


(Address).


32 So. Common St. Lynn 12/1/61


Vernon Grove Cem. Milford, Mass 6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL December 5 .19.


6


7 NAME OF


FUNERAL DIRECTOR


Arthur J. O'Maley


ADDRESS.


Winthrop, Mass


Received and filed.


DECEMBER


8, 1961


(Registrar of City or Town where deceased resided)


PARENTS


18 BIRTHPLACE OF


FATHER (City).


(State or country)


Mai ne


19 MAIDEN NAME


OF MOTHER


c/n/b/1


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Maine.


21


Informant.


Arthur J. O'Maley


(Address) 79 Atlantic St Winthrop


A TRUE COPY ATTEST: (Registrar of City or Town where death occurred)


DATE FILED


December 4,1961


.19.


7


3 DATE OF


DEATH


December 1, 1961


(Month)


(Day)


(Year)


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Edward .... A.


(Husband's name in full)


Due To


Hypertensive heart disease


6 yrs


25M-8-56-918227


)RM R-302 1


MARGIN RESERVED FOR BINDING


17 NAME OF


FATHER


Boardman


Registered No.


(Was deceased a


U. S. War Veteran,


if so specify WAR)


no


RECEIVED


TOWA


78 12. 1


140


CLERK


3


5


6


HROB MASS


DEC : 81961 AM


PLACE OF DEATH


Suffolk (County)


Winthrop


(City or Town)


42 Sunnyside 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.


20


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


PHYSICIAN - IMPORTANT


2 FULL NAME


Lawrence


(First Name)


(Middle Name)


J. Ryan Sr.


[(Was deceased a


U. S. War Veteran,


(Last Name)


(if so specify WAR)


170


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


42 " Sunnyside


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


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


December 4


1961


(Month)


(Day)


(Year)


4


HEREBY CERTIFY,


19.


to ...


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


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


have occurred on the date stated above, at


INTERVAL BETWEEN ONSET ANO DEATH


DEATH WAS CAUSED BY : IMMEDIATE CAUSE (a)


Due


(b)


Death apparently due to natural causes,


Due (c) presumably acute


OTHERS SIGNIFICAronary occlusion CONDITIONS plicated by known Was auppfarbetes, What t Winthrop Board of Health


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


(Sig


Chantes Liberman


CHARLES LIBERMANI MID


(PRINT OR TYPE SIGNATURE)


(Address) Winthrop, mass Date


12/4/ 1961


6 Holy Cross Malden


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL December 9, 19 67


7 NAME OF


FUNERAL DIRECTOR


Frederick J. Magrath


ADDRESS


325 Chelsea St. E. oston


Received and filed


....... 19.


(Registrar)


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


Aed Riley


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


71


Years.


Months.


.. Days


If under 24 hours Hours. Minutes


13 Usual


Occupation :


Stevedore


(Kind of work done during most of working life)


14 Industry


or Business :


Retired


15 Social Security No.


022-10-8604


Montreal


16 BIRTHPLACE (City)


(State or country)


Canada


17 NAME OF


FATHER


Patrick Ryan




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