USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1962 > Part 37
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13 DATE OF BIRTH
14 AGE. 54 Years.
If under 24 hours Hours Minutes
.Days
16 Industry or Business ....
Produce
17 Social Security No.
18 BIRTHPLACE (City)
(State or country )
Malden
19 NAME OF
FATHER
Hyman Louis Pastan
(unknown)
Boston
PHYSICIAN - IMPORTANT
(First Name)
(Middle Name)
(Last Name)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
154 Sewall Ave., Winthrop, Mass.
(If nonresident, give city or town and State)
healed myocardial infarction; fracture of right 8th and 9th ribs.
Where did
Boston
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RECEIVED
TOW
11.12
LERK
RULES OF PRACTICE
6
IRODA
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 OCTSY91962AR 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 poison) , 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a collision of railroad train and automobile." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic for (enter name of operation and disease or condition requiring surgery)." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
1 -301A 1
ROTIONS F CITIFICATE ging O DEATH center an one · each and (c)
e not mean of dying, Art failure, el It means apr compli- uk caused
if any, rise to se (a), under- last.
Ins contrib- Ich but not The terminal nlion given
hapter 137, 154. requires to print or h cause or death on I ficates, and 8, Acts of Mires Physi- int or type ur signature.
6
Puritan Lawn Cem.
W'. Peabody
Place of Burial or Cremation Oct. 22, 1962 19
DATE OF BURIAL
7 NAME OF
FUNERAL
DIRECTOR
Leslie W. Pike
ADDRESS
305 Beach St. Revere
Received and filed
OCT 22-1962
.. 19.
( Registrar)
Vale
9 COLOR
White
10 SINGLE (write the word) MARRIED Widowe WIDOWED or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
Frances ....... Kline
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
88
12
AGE
Years .........
.Months ..
......
Days
If under 24 hours
Hours ..
......
Minutes
13 Usual
Occupation :
Tras Station
Owner
(Kind of work done during most of working life)
14 Industry
or Business :
None
15 Social Security No.
Trenton
16 BIRTHPLACE (City)
(State or country)
New Jersey
17 NAME OF
FATHER
Arden Sine
18 BIRTHPLACE OF FATHER (City) Can not be learned
19 MAIDEN NAME OF MOTHER Can not be learned
20 BIRTHPLACE OF MOTHER (City) (State or country)
21 Informant (Address)
Charles. M. Sine
41 Reachland Ave Revere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Tackle C. Pertanto 8 (Signature of Agent of Board of Health or other) Health Officer 10/24/62
(Official Designation) (Date of Issue of Permit)
8145
PLACE OF DEATH
Suffolk
NEVERZ 29-8-11
CONSE PETIT
STANDARD
CERTIFICATE OF DEATH
Registered No.
184
[(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)
(If deceased is a married. widowed or divorced woman, give also maiden name.)
41 Beachland Ave
Revere
.. St.
60
(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.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October 18, 1962
(Month)
(Day)
(Year)
4 I HEREBY
JAN. 5
CERTIFY
1962, to
2
That I attended deceased from
62
I last saw hickalive on CeX18, 1962
death is said to
have occurred on the date stated above, at
4 30 Pm.
INTERVAL BETWEEN ONSET AND DEATH
Due To (b) GENERLiZe / ARTERIOSCLEROSIS
Due To (c)
CORONARY HEART DISEASE
1272
OTHER SIGNIFICANT CONDITIONS
CARDIAC FAILURE
3/200
Was autopsy performed?
100
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? a. If so, specify
(Signed) andrew Catino M. D. (State or country)
ANDREW CATINO, MD
(Address) LC3 BROADWAY
(PRINT OR TYPE SIGNATURE)
OCT 19 962
REVERE, MASS
PARENTS
To be filed for burial permit with Board of Health or its Agent.
(County)
Winthrop
(City or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
Winthrop Convalescent Home 142. Pleasant St Charles W. Sine
2 FULL NAME
(First Name)
(Middle Name)
(Last Name)
(a) Residence. No.
(Usual place of abode)
3
(Give maiden name of wife in full)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
CARDIAC DeCOMPENSATION
(a)
2 7/10
(City or Town)
1
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RECEIVED
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER.
TO !!
6
RULES OF PRACTICE
The fulfillment of the purpose of these laws call for the Sofern ance 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.
CIM R-301
or burial permit di of Health Agent. ACTIONS R ERTIFICATE
R TYPE C CAUSES ['ATH n enter ian one eor each ) and (c)
h: not mean d of dying, .art failure, c. It means u or compli- jich caused
jus, if any, we rise to use (a), se under- use last.
dons contrib- ath but not o he terminal audition given C
X PLACE OF DEATH
Suffolk
(County)
1
Winthrop
(City or Town)
No.
46 Read Street
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No. 185
f(If death occurred in a hospital or institution, .St. ( give its NAME instead of street and number)
2 FULL NAME
John G. Swansburg
(If deceased is a married, widowed or divorced woman, give also maiden name.)
4
46 Read Street
St
(If nonresident, give city or town and State)
32
;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)
widowe).
11 If married, widowed, or forced.
HUSBAND of
Cathrine E Mac Donald (Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
12
AGE.
Years.
73
4
.Months.
2
.Days
If under 24 hours
Hours ... ..
.Minutes
13 Usual
Occupation :
Expressman Mind of work done during most working life)
14 Industry
or Business :
Trucking.
15 Social Security No.
015-32-6927
16 BIRTHPLACE (City) ....
(State or country)
21
1 Wobund Man
17 NAME OF
FATHER
Thomas & Swansbury.
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Jane M Mckay.
20 BIRTHPLACE OF
MOTHER (City).
(State or country)
Nova Scotia
Donald Swanburg,
21 Informant
(Address)
46 Read St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Palble " pirrande 9
(Signature of/Agent of Board of Health or other)
Heatile Officer 10/2 16=
(Registrar) |(Official Designation)
(Date of Issue of Permit)
1 1.B.V
-
PARENTS
Place of Turial or Cremation Det 22 62
(City or Towny
DATE OF BURIAL
19
7 NAME OF
Ernest Plaggiano
ADDRE
147 Wintherof St Winthrop
Received and filed
OCT 22 1962
19
......
6-932382
TRUE COPY ATTEST: RUE COPY ATTEST:
(Day)
4 I HEREBY CERTIFY , That I attended deceased from
19 ........
to.
19
-
1 last saw h ...... alive on
19
...... , death is said to
have occurred on the date stated above, at 11:00 Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Natural Causes
INTERVAL BETWEEN ONSET AND DEATH
Due
(b)
Presumably Coronary
Sudden
Due To
(c)
Occlusion
Arteriosclerotic Heart Disease
OTHER SIGNIFICANT CONDITIONS none
10 yrs.
Was autopsy performed? no
What test confirmed diagnosis? post-mortem judgement
5 Was disease or injury in any way related to occupation of deceased ? Ano If so, specify
(Signa Arthur @. Murray M. D.
Arthur C. Murray
(Print or Type Name) Winthrop Board of Health Date 19 Oct 162
Winther 6
Winthrop
(City or Town making this return)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran, no
if so specify WAR)
Winthrop
(a) Residence. No.
(Usual place of abode)
Length of stay: In place of death.
32
.years .......... months .......... days. In place of residence.
3 DATE OF
DEATH
October
18
1962
(Year)
(Month)
(a)
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE OCT 2 21962 PM
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 Heaith 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) Medicai Examiners will investigate and certify to ali deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resuiting 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.
PLACE OF DEATH
Suffolk (County) 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 filed for burial permit with Board of Health or its Agent
186
Bayview Nursing Home No.
2 FULL NAME
Mary E. Jaquith
(If deceased is à married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
19 Moore
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.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
White
9 COLOR
10 SINGLE
(write the word)
MARRIED
Widowed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Perley H. Jagwith
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
82
AGE-
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:
At Home
15 Social Security No ..
None
16 BIRTHPLACE (City)
(State or country)
Norwich, Conn.
OTHER
SIGNIFICANT
CONDITIONS
Blindness
1 yr.
Was autopsy performed ?__ no
What test confirmed diagnosi
Clinical & Laborator
5 Was disease or injury in any way related to occupation of deceased ? NO
If so, specify ..
mi Traunstein
SALUD.
(Signed)
M. Traunstein, Jr.,_, M. D.
(Address)
73 Bartlett Rd. Date Oct. 22,62
6
DATE OF BURIAL October 25 6
19
7 NAME OF
FUNERAL DIRECTOR Frederic J. Crosby
867 Beacon St., Boston
ADDRESS
Received and filed
OCT 23 1962
19
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Unable to learn
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Informant
(Address)
26 Willow St. W. Roxbury
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). Kkalthe Officer 10/25/12
(Official Designation)
(Date of Issue of Permity
X
3 DATE OF
DEATH
October
22. 1962
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
December 1955
to
October 22 . 162
I last saw BY alive on October 22. 19.62, death is said to
have occurred on the date stated above, at
8:25a.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE (a) Arteriosclerotic & Hyper- tensive heart disease
INTERVAL
BETWEEN
ONSET AND
DEATH
6 yrs
Due ToGeneralized arteriosclerot (b) sis
0the
Cerebral arteriosclerosis
8 yrs
1 yr.
50M-1-58-921876
MI-301A 1
/
0 9.8
11
RTIONS
L RTIFICATE
iring C DEATH al enter in one er each ( and (c)
dr not mean de of dying, art failure, e. It means 54 or compli- sich caused
01 if any, Be rise to ase (a), e under- muse last.
it is contrib -- > luth but not o he terminal o'ition given
· hapter 137, 4, requires to print or cause or death on elfcates.
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,
No
if so specify WAR)
Winthro
(Usual place of abode)
Scotland
Zion Hill Cemetery Hartford Place of Burial or Cremation (City or Town Conn 21 Mr.Edward W. Jaquith
17 NAME OF
FATHER
William Blackburn
Scotland
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness. at the request of an undertaker or other authorized person or of any member of the family of the deceased. furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased. his supposed age. the disease of which he died. defined as required by section one, where same was contracted. the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall. if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it Has been. engaged, insert in the certificate a recital to that effect, specifying the war.land shall also certify in such certificate both the primary and the secondary or imme-" diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall. for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border !!! ling rules of practice: service of nineteen hundred and sixteen and nineteen hundred and. seventeene) G. L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town person died; and no undertaker or other person shall exhume a human remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be. a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician. if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health. or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body. not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents'or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6 , as amended by Chap. 632, Sec. 4. Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof I , which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried "or the funeral is to be held, or from a person appointed to have the care of the .cemetery or burial ground in which the interment is made.
Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow-
-(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 deathsonly 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 losdomy when the certificate of death is needed.
DET 31936 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 occupatión, 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.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING. ORGANIZATION AND OUTFIT
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