USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1961 > Part 9
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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
11 IF STILLBORN, enter that fact here.
12
53
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Meat Checker
10 mof Industry
First National Stores
or Business :
15 Social Security No.
16 BIRTHPLACE (City)
(State or country )
Cty. Calway, Ireland
17 NAME OF
FATHER
Patrick Kennedy
Was autopsy performed?
yes
What test confirmed diagnosis ?
Biopsy.
5 Was disease or injury in any way related to occupation of deceased ? If so, specify
BARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country) Cty . Galway, Ireland
(Signed)
Francis F. Smith
M. D.
(Address )
85 Otis St. Camb ...
har. 30
winthrop
20 BIRTHPLACE OF
MOTHER (City )
State or cou
Cty. Galway, Ireland
Nora Burke
Informant
( Address )
9 Atlantic ~ Es Winthrop
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS
79 Atlantic St. inthrop
Received and filed
APR 11 1961
19
ATTEST :
(Registrar of City or Town where death occurred)
DATE FILED
Mar. 7,
19 61
V. B.V
(b) 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 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)
IM R-302
THIS IS A PERMANENT RECORD
()
50M-9-59-926111
( Registrar of City or Town where deceased resided )
10a If married, widowed, or divorcedr
19
HUSBAND of
ilora Kennedy
(Give maiden name of wife in full)
(or) WIFE of.
( Husband's name in full)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) CerebellarMetastases
10 MDAGE
Irs
.Months .......... Days
Due To
Carcinoma of the Lung ..
( Kind of work done during most of working life)
OTHER
SIGNIFICANT
CONDITIONS
19 MAIDEN NAME
OF MOTHER
Kate Mellody
Winthrop Cemetery 6
Place of Burial or Cremation DATE OF BURIAL
March 6, 19
(City or Town)
A TRUE COPY Frades. ( ,,
1
Michael Burke
( Was deceased a
U. S. War Veteran.
(if so specify WAR,
RECEIVED
6
SPACE FOR ADDITIONAL INFORMATION
APR-2-44961 .. 001
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)
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.
41
§(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Anna .... C ....... Campbell
( First Name)
(Middle Name)
(Last Name)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
156.Somerset .... Ave
(L'sual place of abode)
Length of stay :
In place of death.
years.
months ..
8
days. In place of residence ..
10 ...
years
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March3, 1961
(Month)
(Day)
(Year)
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
or DWANGowed
4 I HEREBY CERTIFY,
That I attended deceased from
19 ..
..... , to ......
Marin
19.67
I last saw h.s.k.alive on
manche 3 1961
death is said to
have occurred on the date stated above, at
7:40 Pm.
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Archibald F. Campbell
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
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.
16 BIRTHPLACE (City)
(State or country)
East ..... Boston
Mass
17 NAME OF
FATHER
Olaus Olson
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Sweden
19 MAIDEN NAME
OF MOTHER
Carlotta Krona
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Sweden
21
Informant
....
Hazel ..... Mac.Donald
(Address) 150 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: Ralph E, Serianni ( Signature of Agent of Board of Health or other) atte 3/6/6/
HO
1 ......
(Official Designation)
(Date of Issue of Permit)
CTIONS OR ERTIFICATE
iving F DEATH : enter an one or each ) and (c)
not mean of dying, art failure, c. It means or compli- ich caused
is, if any, Je rise to use (a), te under- use last.
ns contrib- ith but not he terminal 'ition given
Chapter 137, 54. requires s to print or cause or death on ificates, and $8, Acts of aires Physi- rint or type per signature.
1
ADDRESS
Received and filed
MAR 6 1961
19
(Registrar)
PARENTS
Glenwood
6 Place of Burial or Cremation
Everett Mass.
(City or Town)
DATE OF BURIAL
March 7
19.61
7 NAME OF
FUNERAL DIRECTOR
Arthur J. 0'Maley
Winthrop Mass
M. D
(Signed)
Joseph GRIGORIE
(PRINT OR TYPE SIGNATURE)
(Address)
194 Washusten 26 Date.
9/4
1961
Was autopsy performed?
What test confirmed diagnosis?
INTERVAL
BETWEEN
ONSET AND
DEATH?
1/sur
12
AGE ..
78
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Acute let + Ventric
(a)
....
ular Failure
Due To
(b)
arterioscleratic
gros
Due To
Heart Disease
(c)
arteriosclerosis -gen
yr
OTHER SIGNIFICANT CONDITIONS
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
Mi
Registered No.
[(Was deceased a U. S. War Veteran.
(if so specify WAR) NO
St.
(If nonresident, give city or town and State)
(write the word)
028145
R-301A 1
No. Winthrop Community Hospital
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.
OF
TOW
Er
MAR - 61961 FM
1
Winthrop
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filled for burial permit with Board of Health or its Agent.
Registered No.
42
[(If death occurred in a hospital or institution, St. [give its NAME instead of street and number) -
2 FULL NAME
Samuel Weiner
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
No
(a) Residence. No. ..
(Usual place of abode)
246 Shore Drive
St.
Winthrop Mass
(If nonresident, give city or town and State)
Length of stay: In place of death.
.years.
months ..
days. In place of residence.
14 years
months.
... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
March 3rd 1961
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
That I attended deceased from
October, 1952
to
March 3
1966 L.
I last saw himlalive on
March 2, 1961, death is said to
have occurred on the date stated above, at
9:10 A. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Coronary
Occlusion
aculté
Du
Coronary Artery Heart
(b)
Diseasel.
Due To
Arteriosclerosis,
(c)
OTHER
SIGNIFICANT
None
CONDITIONS
Was autopsy performed?
NO
What test confirmed diagnosis?
Clinical
5 Was disease or injury in any way related to occupation of deceased ?/
If so, specify .....
Charles Liberman
No
(Signed).
Charles Liberman
M. D.
WinthropMosDate 3/3/196
Bessarabian Cem 6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
March 5th
19.61
7 NAME OF
FUNERAL DIRECTOR
Philip Briss
ADDRESS
470-
arvard Street, Bkln Mass
Received and filed
3-3-61
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWEDmarried
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of Tina Halpern
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
DEATH
I bank.
Years
66
Months
Days
If under 24 hours
.Hours ....... Minutes
13 Usual
Occupation :
retail meats
(Kind of work done during most of working life)
14 Industry
or Business:
retired.
15 Social Security No ...
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
Morris Weiner
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
Hinda (unknown)
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21
Informant
Mrs Tina Weiner
(Address) 246 Shore Drive, 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. Spercannes (Signature of Agent of Board of Health or other)
HO 3/3/6/
(Official Designation)
(Date of Issue of Permit)
UBV
-THIS IS A ENT RECORD. e only APPROVED nk or black iter ribbon.
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each b) and (c)
oes not mean of dying, heart failure, tc. It means or compli- which caused
s, if any, ve rise to ause
(a), the under- ause
last.
ons contrib- cath but not the terminal Audition given
hapter 137, 54, requires to print or cause or death on ficates.
2. 46, šť 9 & 2. 114 §§ 45, .P. 38 $ 6.)
-58-923886
PLACE OF DEATH
Suffolk (County)
No.
246 whore Drive, Winthrop
INTERVAL BETWEEN ONSET AND
10yrs
5 yrs.
PARENTS
(Address)
Everett Mass
[ R-301A
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 follow- ing rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation. the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .-- 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.
IM R-304
1 giving USE OF AL DEATH not enter e than one se for each (a), (b) and (c)
or maternal ion causing death (do use such as stillbirth maturity. ) and/or ma- conditions, . which gave to above (a), stating nderlying last.
utions of fetus Other which ave contrib- to fetal t but, in so · is known. e not related cuse given ().
15M-6-60-928241
Suffolk (County ) PLACE OF DELIVERY No. Winthrop Community Hospital
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS CERTIFICATE OF FETAL DEATH ( STILLBIRTH)
To be filed for burial permit with Board of Health or its Agent.
Registered No.
43
(If death occurred in a hospital or institution, -
give its NAME instead of street and number)
3 DATE OF
DELIVERY
3/5/61
(Month )
(Day)
(Year)
4 SEX X
Male .... Female ...... Undetermined
5 COLOR (if
determined) .
W
6 THIS BIRTH (Check one)
Single.X.
Twin
Triplet
7 IF MULTIPLE BIRTH, BORN :
1st.
.2nd
.. 3rd.
FATHER
MOTHER
14
MAIDEN NAME
Florence Buonopane
PRESENT NAME Florence Buonopane
RESIDENCE, NO.1115 Saratoga St., CITY OR TOWN E. Boston
STATE
Mass ..
STREET
15
RESIDENCE, NO. 1115 Saratoga St.,
CITY OR TOWN E. Boston
STATE ... Mass ..
10 COLOR OR
RACE White
11 AGE AT TIME OF
THIS DELIVERY
40
(Years)
16 COLOR QR
RACE White
17 AGE AT TIME OF THIS DELIVERY 40 (Years)
12 PLACE OF
BIRTH
(City or Town)
Italy
(State or country)
18 PLACE OF
BIRTH
(City or Town)
Italy
(State or country)
19 INFORMANT Alberico Buonopane
20 PREVIOUS DELIVERIES TO MOTHER
(Do not include this fetus )
6
(a) How many children are
now living?
6
(b) How many children were born alive but are now dead ? 0
(c) How many previous fetal deaths of ANY gestation age ?
21 LENGTH OF PREGNANCY
abmit 20 completed
weeks
(or
...
Grams )
23 WHEN DID FETUS DIE? Before Labor
24 AUTOPSY
Yes
No
25 FETAL DEATH WAS CAUSED BY : IMMEDIATE CAUSE
DIED in UTERO- Cause Unknown.
(a)
Due To (b) Due To (c)
OTHER SIGNIFICANT CONDITIONS
26 Holy Cross Cemetery Malden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
March .8,
27 NAME OF FUNERAL DIRECTOR Vincent Rapino ADDRESS 9 ChelseaSt., East Boston
Received and filed
MAR 8 1961
19
A TRUE COPY ATTEST :
(Registrar )
I HEREBY CERTIFY that this delivery occurred on the date stated above at 6.2 m., and product of conception was not a live birth.
Signature of trending Physician on Medical Examiner: D. Thomas Stoffer
M. D.
D. Thomas Staffier (PRINT OR TYPE SIGNATURE)
Addres
19 Breed St., East Boston
19
I HEREBY CERTIFY that a satisfactory certificate of fetal death was filed with me BEFORE the burial or transit permit was issued : 7 Ralph E Siwann
CHCISignature of Agent of Board of Health or other) H.O 3/8/6/
(Official Designation )
(Date of Issue of Permit ) >
1
1 Winthrop (City or Town)
2 NAME OF FETUS (if given)
Paby Poy Buonopane
St.
8
FULL
NAME
Alberico Buonopane
.
STREET
13 OCCUPATION Candy Maker
22 WEIGHT OF FETUS
Lb. 10 /2 Oz.
During Labor
or Delivery.
Unknown
FETAL DEATH
TO!
EXTRACTS OF CERTAIN SECTIONS OF CHAPTER 46 AS AMENDED OR ADDED BY CHAPTER 48. ACTS OF 1960.
Section 2A. "Examination of records and returns of illegitimate births, or abnormal sex births, or fetal deaths, . . . shall not be permitted except ... ".
Section 9A. When a child is born dead, after a period of gestati MAR # 81961 PM ot less than twenty weeks, and in the fetus there is no attempt at respiration, no action of heart and no movement of voluntary muscle, the physician or officer attending at the birth of such child shall forthwith furnish for registration, at the request of an undertaker or other authorized person or of any member of the family of the deceased, a certificate of fetal death on a form which shall be prepared by the secretary of state as required by section sixteen. Town clerks shall record certificates of fetal death in the town register of deaths in the same manner as a death certificate, but they shall not be required to record such certificates in the town register of births.
Section 12. ". .. No birth record of a child born out of wedlock or of a child of abnormal sex, and no record of fetal death shall so be transmitted to any other city or town."
Section 24. In any statement of births, deaths and fetal deaths printed by a town the name of an illegitimate child or of its parents or of the parents of a child born dead shall not be printed, but the word "illegitimate" or "fetal death" shall be used in place thereof. A town violating this section shall forfeit to the mother of such child not more than one hundred dollars.
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
Registered No.
44
No. Winthrop Community Hospital
2 FULL NAME
Mary J. Cardoza
(If deceased is a married, widowed or divorced woman, give also maiden name.)
62 Cottage Avenue, Winthrop
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.
years.
.months ..
5
days. In place of residence .. 32.
.. years
.........
.months ..
.........
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
(write the word)
WIDOWED Widowed| or DIVORCED
10a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Matthew E ...... Cardoza
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE82
Years ..
4
Months ..
9 ... 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.
No
16 BIRTHPLACE (City)
Azores
(State or country)
Portugal
17 NAME OF
FATHER
Manuel Benavidz
Azores
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Portugal
19 MAIDEN NAME
M. D.
OF MOTHER
Anna DeRego
20 BIRTHPLACE OF
MOTHER (City)
Azores
(State or country)
Portugal
21
Miss Mary H ....... Cardoza-dau.
Informant
(Address)
62 Cottage Ave. Winthrop
I HEREBY CERTIFY that a satisfactory Standard certificate of death was filed with me BEFORE the burial or-transit permit was issued: Palkh &
(bignatyfe of Agents of Board of Health or other)
H.O.
3/6/61
(Official Designation)
(Date of Issue of Permit)
JCTIONS OR CERTIFICATE
riving OF DEATH
·t enter han one for each b) and (c)
's not mean of dying, heart failure, tc. It means , or compli- hich caused
is, if any, ve rise to zuse (a), he under- luse last.
ions contrib- ath but not the terminal dition given
hapter 137, 4. requires to print or cause or death on icates, and , Acts of res Physi- int or type signature.
(Signed)
Myron n. 1mg
MIRON N. KING M.D
(PRINT OR TYPE SIGNATURE)
(Address) 222 PLEASANT
·WINTER.
Date ...
3/5
, 61
Winthrop Cemetery,
Winthrop
6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
March
8th
19
61
7 NAME OF FUNERAL DIRECTO Richard C. Kirby, Inc. ADDRES 917 Bennington St. , E.Boston
Received and filed
MAR 6 1961
19
(Registrar)
5 YRS.
Due To (c)
OTHER
DIABETES MELLITUS- MILD
SIGNIFICANT
CONDITIONS
DECUBITUS ULCER
5 DAYS
Was autopsy performed ?
What test confirmed diagnosis ?
CLINICAL
5 Was disease or injury in any way related to occupation of deceased: O If so, specify
PARENTS
3 DATE OF
MARCH
5
1961
DEATH
(Month)
(Day)
(Year)
4 I HEREBY
CERTIFY
That I attended deceased from
MAR 51
19%
I last saw he native on
MAR 5
, 1961
death is said to
have occurred on the date stated above, at
7:20 Am.
INTERVAL
BETWEEN
DNSET AND
DEATH
2 WKS.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
CEREBRAL VASCULAR ACCIDENT
WITH RT HEMIPLEGIA
Due To
(b)
ARTERIO-SCLEROTIC + HYPER-
TENSIVE HEART DIS
to ...
MAR 5
61
PHYSICIAN - IMPORTANT
[(Was deceased a
U. S. War Veteran,
lif so specify WAR)
No
(a) Residence. No. (Usual płace of abode)
[(If death occurred in a hospital or institution,
St. ? give its NAME instead of street and number)
(Benavidz)
To be filed for burial permit with Board of Health or its Agent.
R-301A 1
.59-926662
TOW ¡
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE. 3 DATE OF DISCHARGE.
: RANK, RATING THRC.R.
ORGANIZATION AND OUTFIT
MAR =6196T "AM 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
R-301A
1
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. 45
[(If death occurred in a hospital or institution,
St ? give its NAME instead of street and number)
PHYSICIAN - IMPORTANT f(Was deceased a U. S. War Veteran, no
if so specify WAR)
(a) Residence. No.
218 Lincoln Street
(Usual place of abode)
St.
Winthrop
(If nonresident, give city or town and State)
Length of stay: In place of death ..
3
.. 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
MARRIED
(write the word)
WIDOWED
or DIVORCED Widowed
4 I
HEREBY CERTIFY,
19.07, to Marele 8
That I attended deceased from
61
l last saw h.).Mfalive on .
march 3
, 19 61
death is said to
have occurred on the date stated above, at
1:50pm.
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
Years
Months.
28
.Days
If under 24 hours
Hours .............. Minutes
13 Usual
Occupation :
Contractor
(Kind of work done during most of working life)
14 Industry
or Business :
Building
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Italy
17 NAME OF
FATHER
Anthony Delmonico
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
Salerno
19 MAIDEN NAMEouise Tetore
1 D. OF MOTHER
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
Mrs. May G. Gaffny
DATE OF BURIAL ... March 13.
19.
61
7 NAME OF
FUNERAL DIRECTOR
Ernest P .Caggiano
ADDRESS
147 Winthrop St. Winthrop
Received and filed MAR 10-1961 19
(Registrar)
PARENTS
6 .Assumption Cemetery., Syracuse, .... N. Y.21 Place of Buffal or Cremation (City or Town)
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