USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1962 > Part 30
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I X PLACE OF DEATH
Poster ×7-X-8
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
(City or Town making this return)
STANDARD CERTIFICATE OF DEATH
Registered No.
149
f(If death occurred in a hospital or institution, No
St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME Michael DiFronzo
(If deceased is a married, widowed or divorced woman, give also maiden name.)
72 StAndrew Road
St
East ..... Boston ... Mass
(a) Residence. No.
(Usual place of abode)
Length of stay: In place of death ....... years 1 months 8
.days. In place of residence .. 32years. ........ months .......... days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
DIVORCED Widowed
UNKNOWN
11 If married, widowed,, or. divorced
HUSBAND of
Philomena Casoli
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12
AGE.Z.9.Years.
11
Months.
28
Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :...
Bartender
(Kind of work done during most working life)
14 Industry
or Business :
Taverns
15 Social Security No.
023-24-3538
16 BIRTHPLACE (City)
(State or country )
Italy
17 NAME OF
FATHER
Nicola DiFronzo
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Concetta Gregorio
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
21 Informant
Mr. Angelo DiFronzo-son
70 Bickford Ave., Revere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Falah 6. Viviane (HB)
(Signature of Agent of Board of Health or other)
Health Office
5/14/62
(Date of Issue of Permit)
-62-932382
ORM R-301
le for burial permit Jard of Health Its Agent. N RUCTIONS FOR C CERTIFICATE
N OR TYPE JOR CAUSES IDEATH linot enter c: than one le for each a (b) and (c)
sdoes not mean nde of dying, il heart failure, etc. It means iise, or compli- s which caused
ions, if any, e gave rise to cause (a), the under- cause last.
·ditions contrib- death but not Go the terminal econdition given )
(Signature)
LC 10.
Patito
M. D.
D. D. Pot, to hit
(Print or, Type Name)
12A Ban Dutcht1 St Date 8113 1962
Fast POST 7115
Holy Cross Cemetery
6
Place of l'urial or Cremation
(City or Town)
DATE OF BURIAL
August 16th
19 62
7 NAME OF FUNERAL DIRECTOR Richard C. Kirby, Inc. ADDRESS _ Bennington St. ,E. Boston
Received and filed
AUG 14 1982
19
.......
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Aug
13
1962
(Year)
(Month)
(Day)
1962
4 IHEREBY CERTIFY , That I attended deceased from
July 5
1962
to ..
Cinq
13
Plast saw hahalive on
SLUG 13
1902 death is said to
have occurred on the date stated above, at 11:56 Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Carcinoma
of Sigmond
Due To
Colon with Extension
Due To
into Urinary Bladder
(c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
no
What test confirmed diagnosis ?
op. 7/12/62
5 Was disease or injury in any way related to occupation of deceased? If so, specify 426
(Address)
Suffolk (County)
Winthrop (City or Town)
Winthrop Community Hospital
(Was deceased a
U. S. War Veteran,
if so specify WAR).
No
(If nonresident, give city or town and State)
(write the word)
INTERVAL BETWEEN ONSET AND DEATH
3 mos
PARENTS
(Registrar) (Official Designation)
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE
THA Wanie 1962 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 froin 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.
FORM R-301
I for burial permit oard of Health ‹its Agent.
1. TRUCTIONS FOR IL CERTIFICATE
IT OR TYPE JS OR CAUSES ( DEATH
I not enter nr'e than one cise for each (, (b) and (c)
k. daes mat mean ode of dying, I heart failure, et:, etc. It means dease, or campli- m which caused h
mitions, if any, ki gave rise ta e cause (a), as the under- à cause last.
(nditians contrib- ga death but nat le to the terminal a: candition given
PLACE OF DEATH
Suffolk (County)
3.x213
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
150
[(If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Lulu
Sullivan
(Hatch)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
3 Oak Island Rd.
(a) Residence. No.
(Usual place of abode)
Length of stay: In place of death .......... years .......... months .:
days. In place of residence.
3years
... months.
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August
20
1962
(Month)
(Day)
(Year)
4^I HEREBY CERTIFY , That I attended deceased from
20, 196.2, to ...
August 20
19 62
I Vlast saw h Stalive on
19 62 death is said to
have occurred on the date stated above, at 3:25Pm.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) LymphoSarcoma
Due To (b)
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
NO
What test confirmed diagnosis ?
OperAtion-
5 Was disease or injury in any way related to occupation of deceased? I'd If so, specify
(Signature)
18 aurez
M. D.
HARRY M/ WIENER M.D
(Address)
Recur Mass
Date KL 21 1962
6
Woodlawn
Everett
Place of Burial or Cremation
(City or Town)
August 23,
62
19.
7 NAME OF
FUNERAL DIRECTOR
McGlinchey Funeral Home
By_Leo M.Norton
ADDRESS
583 Broadway Chelsea
Received and filed
AUG 22 1962
19
(Registrar)|
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
(write the word)
Female
White
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN Widowed
11 If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Dennis
Sullivan
(Husband's name in full)
12
AGE ..
45 Years ..
.Months.
.Days
If under 24 hours
Hours. .
Minutes
13 Usual
Occupation :
At Home
(Kind of work done during most working life)
14 Industry or Business :
15 Social Security No ......
16 BIRTHPLACE (City)
(State or country )
Chelsea
17 NAME OF
FATHER
Carl Hatch
18 BIRTHPLACE OF
FATHER (City)
N. Hampshire
(State or country)
19 MAIDEN NAME
OF MOTHER
Olie Rowell
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Newburyport
21 Informant
WilliamE.Hatch
I77 Central Ave. Chelsea
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: 6. Virianni
(Signature of Agent of Board of Health or other)
Health Officer
Cura. 22. 1962
(Official Designation)
(Date of Issue of Permit)
Y :- 62-932382
I
Winthrop
(City or Town)
AST
Mount's Rest Home
No.
(Was deceased a
U. S. War Veteran,
(if so specify WAR).
Revere
No
St
(If nonresident, give city or town and State)
14
(City or Town making this return)
PARENTS
DATE OF BURIAL
(Print or Type Name)
INTERVAL BETWEEN ONSET AND DEATH
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
6
HROP
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.
AUG 2 21962 AM
1
PHYSICIAN - IMPORTANT
2 FULL NAME ..
William Paron
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a U. S. War Veteran, if so specify WAR).
No
(a) Residence. No .....
19 Beach Road
(Usual place of abode)
St
Winthrop
(If nonresident, give city or town and State)
Length of stay: In place of death .......... years .......... months ........ days. In place of residence.
3
ears.
.......
.months ....
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE MARRIED WIDOWED DIVORCED UNKNOWN
(write the word)
Married
I If married, widowed, or divorced
HUSBAND of
Ett.a .... Pollack
(or) WIFE of
(Husband's name in full)
12
AGE
77 ears
Months.
.Days
If under 24 hours
Hours ..
Minutes
13 Usual
Occupation :
(Kind of work done during most working life)
14 Industry
or Business:
Hardware
15 Social Security No .....
cannot be learned
16 BIRTHPLACE (City)
(State or country )
Russia
17 NAME OF
FATHER
Sholom Baron
18 BIRTHPLACE OF
FATHER (City).
Russia
(State or country)
19 MAIDEN NAME
OF MOTHER
Esther Tock
20 BIRTHPLACE OF MOTHER (City) (State or country)
Russia
6
Ohavey Zedek
West Roxbury
Place of Turial or Cremation
(City or Town)
DATE OF BURIAL
August
22
1962
7 NAME OF
FUNERAL DIRECTOR
Paul R. Levine
ADDRESS
470 Harvard St., Brookline
Received and filed AUG 2 L 1952 19
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
WINTHROP
(City or Town making this return)
1
Winthrop
(City or Town)
No ....
PLACE OF DEATH
FORM R-301
ill for burial permit 1 oard of Health tits Agent. II TRUCTIONS FOR ILL CERTIFICATE
IT OR TYPE S OR CAUSES C DEATH ( not enter ne than one case for each (, (b) and (c)
hi does not mean ode of dying, heart failure, en, etc. It means diase, or compli- n which caused h
n tions, if any, hs: gave rise to o' cause (a), alg the under- is cause last.
(sditions contrib- sh death but not e to the terminal is condition given
Was autopsy performed?
NO
What test confirmned diagnosis ?
Clinical
5 Was disease or injury in any way related to occupation of deceased ?".0 If so, specify .......
(Signature)
M. D. CHARLES LIBERMAN
(Address)
(Print or Type Name) WINTHROP, MAS Date 8/21/1962
PARENTS
21 Informant
Mrs. Etta Baron
(Address)
19 Beach Rd., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Prish Sirianni
(Signature of Agent of Board of Health or other) Health Officer 8/21/62
(Registrar) (Official Designation)
(Date of Issue of Permit)
3 DATE OF
DEATH
Aug.
(Month)
(Day)
21,
1962
(Year)
4 I HEREBY CERTIFY,
14he
59
Aug1
21
That I attended deceased from
19
62
I last saw hinalive on
Aug120
. 19 62, death is said to
have occurred on the date stated above, at
4:45 Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Coronary Artery Heart
Disease
Due To Arteriosclerosis,
(b)
2 yrs.
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
None.
INTERVAL BETWEEN ONSET AND DEATH Tyr.
H -62-932382
Suffolk (County)
Registered No.
151
Winthrop Community Hospital
§(If death occurred in a hospital or institution, St. ( give its NAME instead of street and number)
(Give maiden name of wife in full)
Salesman
to ...
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
6
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of following rules of practice: (1) Attending physicians will certify to such deaths on AUG 2 11962 TH 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 froin disease resulting from injury or infection related to occu- pation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very impor- tant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Chil- dren not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook- hotel, etc. For a person who had no occupation whatever write none.
1
X
Suffolk
(County) Revere
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
318
Revere
(City or town making return)
Registered No.
(City or Town)
On sidewalk at 184 Broadway, Revere, (If death occurred in a hospital or institution, No. . St: { give its NAME instead of street and number)
Alfonso Celata
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.) 573 Pleasant
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .............. years .............. months.
.days. In place of residence .............. years ............... .. months .............. days.
PERSONAL AND STATISTICAL PARTICULARS
9 SEX Male
10 COLOR
White
11 CITIZEN
OF U.S.
YES
NO
12 SINGLE MWBRIEDI WIDOWED DIVORCED UNKNOWN
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.) Coronary Occlusion.
12a If married, widowed, Somfvodca DeLuca
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
13 DATE OF BIRTH
59
14
AGE
.Years ...
.......
.. Months ..........
Days
If under 24 hours
Hours
Minutes
Foreman Construction
If accidental, was injury causally related to the death ?
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
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 ? If so, specify
(Signed)
Michael A. Luongo
(Address)
Holy Cross Cemetery, Malden 7 ... Place of Burial or Cremation
DATE OF BURIAL
19
8 NAME OF
Lillian Cataldo
FUNERAL DIRECTOR
ADDRESS 374 Broadway, Som., Mass.
Received and filed C- 1962 19
A TRUE COPY.
ATTEST :
"Registrar of City orcmom where death occurred)
DATE FILED
August 24,
19.62
25M-3-61-930213
PLACE OF DEATH
R-305 1
. 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 INIS IS A PERMANENT RECORD
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August 21, 1962
(Month)
(Day)
(Year)
5 Accident, suicide, or homicide (specify)
Date and hour of injury 19
15 Usual
Occupation :
(Kind of work done during most of working life)
16 Industry
Appel Construction Roxbury
or Business :
17 Social Security No. Boston
18 BIRTHPLACE (City)
(State or country)
M&s.S.
19 NAME OF
FATHER
Michael Celata
20 BIRTHPLACE OF FATHER (City) (State or country)
Italy
21 MAIDEN NAME Josephine Rizzo OF MOTHER
22 BIRTHPLACE OF
MOTHER (City)
(State or country)
Italy
23 Esther Celata
Informant
(Address)
373 Pleasant St., Winthrop
(Registrar of City or Town where deceased resided)
PARENTS
NO
"Boston 8/21/ 162 .. Date. .....
(City or Town)
August 24,
62
Winthrop, Mass.
(a) Residence. No. (Usual place of abode)
11
[(Was deceased a
U. S. War Veteran,
(if so specify WAR)
No
152
1
(Specify type of place)
- 1
SPACE FOR ADDITIONAL INFORMATION
SEP. - 17-1962-11.
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
ORM R-301
le for burial permit hard of Health 01 ts Agent. N RUCTIONS FOR CL CERTIFICATE
N OR TYPE JOR CAUSES .DEATH
i not enter ce than one le for each a. (b) and (c)
sdoes not mean nde of dying, heart failure, - etc. It means isse, or compli- y which caused
ic uions, if any, gave rise to 1 cause (a), the under- cause last.
ditions contrib- death but not do the terminal econdition given
PLACE OF DEATH
(County)
Todas Tor 5-7-62
OMVIETDI The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or Town making this return)
Registered No.
153
[(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, if so specify WAR). No
(a) Residence. No ... 93 Trentonst. E. Boston, MassSt
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death years months.3 days. In place of residence 9 years 8 months 9 days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF DEATH
August.
21. 1962
(Month)
(Day) (Year)
I HEREBY CERTIFY That I attended deceased from 60
Kg 17, 19
I last say h.Clalive on Cela 21, 196, death is said to have occurred on the date stated above, at 11/10/7 m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
In Jucardial Heart
(a)
Disease
Due To
(b) Q
to rio sclerosis
Due To en ili + 4 (c) .Cm
OTHER SIGNIFICANT CONDITIONS -
Was autopsy performed?
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased ? If so, specify
(Signature)Deeper Sie M. D. Joseph GREGORIE ....
(Address) 194 Washington Date winthrop Holy Cross Cemetery,' Malden 6
Place of Turial or Cremation
(City or Town)
DATE OF BURIAL
August ..... 24th
19 62
7 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby, Inc
ADDRESS
917 Bennington St. E. Boston
Received and filed
AUG 2º 1962
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F
9 COLOR
W
10 SINGLE
(write the word)
MARRIED
WIDOWED
DIVORCED
UNKNOWN
Widowed
11 If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
Frank B. Greer
(Husband's name in full)
12
AGE.7.9 ... Years.
8
.Months.
.9. . Days
If under 24 hours
Hours ...
.Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most working life)
14 Industry
or Business :
At home
15 Social Security No ....
None
East Boston
16 BIRTHPLACE (City)
(State or country )
Mass
17 NAME OF
FATHER
William J. Flynn
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country) Mass.
19 MAIDEN NAME
OF MOTHER
Katherine Welth
Boston
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
21 Informant
(Address)
Rico Matera-Attorney
163 Meridian Street,
East BostonHass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Falak (HAB)
(Signature of Agent of Board of Health or other)
Hearth Officer 8/22/62-
(Official Designation)
(Date of Issue of Permit)
62-932382
Winthrop. (City or Town)
No.
Winthrop Community Hospital
2 FULL NAME Alice H. Green
(uaiden Flynn )
(If deceased is a married, widowed or divorced woman, give also maiden "name.)
INTERVAL BETWEEN ONSET AND DEATH
yra
yo
(Print or Type Name) e 8/21
19 6.2
PARENTS
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE.
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
TOP
O
THill
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observang &Gth2 21962 AM 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 froin 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.
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