USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1962 > Part 49
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December
11
19.62
(Mouth) (Day)
(Year)
4 I HEREBY
Dec. 7
62
December ell
19
62
19
last saw iefalive on
December 11
...... , 1962, death is said to
to.
have occurred on the date stated above, at12:40pm .. m.
INTERVAL BETWEEN ONSET AND DEATH
2'1 hrs
yoars
Years
Was autopsy performed?
Yes
What test confirmed diagnosis ?
Autopsy
5 Was disease or injury in any way related to occupation of deceased ? If so, specify
(Signature)
Cliccay
M. D.
"Charles L. C(y, & Type Name)
(Address) Avs'y. Dir., Muss. Can't. Homp. ... Date.
Dec. 11. 62
6 Winthrop
winthrop
Place of Burial or Cremation
(City or Town)
December 14
19.
19 62
DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
Howard S Reynolds
ADDRESS
Winthrop, Lass
DEC 14 1962
Received and filed
Charles it Mackie
....
-932382
DECLINED BY MEDICAL EXAMINER
(b)
Due
Small Rowel Volvulus
Due
Periton al Achesions
(c)
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Intestinal Obstruction
(a)
NO. MASSACHUSETTS GENERAL HOSPITAL
ISTAN247 ....
(City or Town making this return)
none
OTHER SIGNIFICANSystadenoma of Ovary CONDITIONS
CERTIFY.
That I_attended deceased from
A TRUE COPY ATTEST,
2. 4. Mackie Cnt, Registrar
- =
FEB 1.0/063 KM
X
PLACE OF DEATH
Suffolk (County)
Boston (City or Town)
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
248
To be filed for burial permit with Board of Health or its Agent.
Registered No.
12331
S(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 Veterao, [if so specify WAR)
2 FULL NAME
Frederick V. Laidlaw
( First Name)
(Middle Name)
(Last Name)
( If deceased is a married, widowed or divorced womao, give also maiden name.)
(a) Resideoce. No.
(U'sual place of ahode)
Somerset. Ave .. ...
.....
St.
Winthrop ..... Mas.s ..
( If nooresident, give city or town and State)
Length of stay:
In place of death .
years .. ..
mooths.
days. lo place of resideoce .. L.2 ... years ............ 0100ths .......
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
(Day)
(Year)
4 1 HEREBY CERTIFY
That I attended deceased from
FEB 4
1957, 10
DEC- IL
EL
I last saw he alive on
19 ..
.. , death is said to
have occurred on the date stated above, at
9 20 Pm
INTERVAL
BETWEEN
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) CEREBRAL VASCULAR ACCIDENT
ONSET ANO DEATH TRAYS
Due To
HYPERTENSIVE AND
(b)
ARTERIO-SCLEROTIC HEART DIS
10YRS
Due To
(c)
GENERAL ARTERIOSCLEROSIS
10YRS
OTHER
SIGNIFICANT OLD CEREBRAL WITH
CONDITION'S
PARTIAL PARALYSIS
10 YRS
Was autopsy performed? N.C.
What test coofirmed diagoosis?
CLINICAL
5 Was disease or injury in any way related to occupation of deceased? ... If so, specify
(Sigoed)
mysen H. King
M. D
MYRON N. KING- M.D.
212 / LENGTHY OR TYPE SIGNATURE)
(Addres DSINTITREA R NAS Date 12/17/062
6 Foly Cross
Talden, Mass
Place of Burial or Cremation (City or Town)
DATE OF BURIAL December 20 1962
7 NAME OF
FUNERAL DIRECTOR
Arthur J. OfMaley
Winthrop, Mass
ADDRESS
DEC 21 1962 ...... 19
Received d filed
11
A
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Hola
9 COLOR
Write
10 SINGLE
(write the word)
MARRIED
WIDOWED,
or DIVORCEDLOWed
10a If married, widowed, or divorced - Toraison
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
AGES
Years
........
Months .....
.Days
If under 24 hours
Hours .............. Minutes
13 Usual
Occupation :
Betired Painter
(Kind of work done during most of working life)
14 Industry
or Business :
15 Social Security No.
037-05-5377
16 BIRTHPLACE (City)
Lowell
(State or country) MESS
17 NAME OF
FATI'ER
William H, Laidlaw
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Annie Christopher
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Terfoundland
21
Informant
Loretta Gallagher
(Address) ]7 Somerset Ave, Winturon
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with me BEFORE the burial of transit permit was issued: L' Dorado,
814313
Signature of Agent of Board of Health or other) Board of highin graber/9
1 -301A 1
RUTIONS F
. CITIFICATE ging O DEATH noenter in one : · each (and (c)
or not mean le of dying, Mrt failure, It means scor compli- wh caused
om if any, & rise to ose (a), under. ale last.
ithis contrib- deh but not De terminal option given
34
- hapter 137, 4. requires a) to print or he cause or death on e ficates, and 3. Acts of eğires Physi- oint or type od. signature.
: 19 1963 Lin Et
PARENTS
OUT
No. 321 Princeton Street
A TRUE LOPY ATTEST:
C cy Registrar
FED Y RI263 MM
01A 1
SEFFELLÍ. (County) BesiEN (('ity or Town) SHINE ELLERBETA (((SD)
The Commomuralth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
249
OUT - OF - TOWN To be filed for burial pe nut with Poord of Health 15 . Ar nt 12624
Registered No.
[(If death occurred in a hospital or institution, St. } give its NAME instead of street and number)
PHYSICIAN - IMPORTANT [ ( Was deceased a U. S. War Veteran.
lif so specify WAR) WINTHROP
( If nonresident, give city or town and State)
months.
.days,
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
MALL
9 COLOR
WHITE
10 SINGLE
MARRIED
WIDOWED
(write the word)
or DIVORCED MARRIED
10a If married, widowed, or divorced
HUSHAND of
(Give maiden name of wife in full)
(or) WIFE of
ALICE 8 HARRINGTON
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 74 Years Months Days
If under 24 hours
Hours.
Minutes
13 Usual
(Kind of work done during most of working life)
14 Industry
or Business :
15 Social Security No. .
011-67-7257
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
GEORGE TIRRELL
18 11IRTHPLACE OF
FATHER (City)
BOSTON
19 MAIDEN NAME
( Address) It Si NoSp. . Date 12/26 .19 ... 6.2 OF MOTHER BOTHILOR LARSEN
WINTHROP 6 Place of Burial or Cremation
WINTHRO
(City or Town)
DATE OF BURIAL
DEC 24
19.62
7 NAME OF
FUNERAL DIRECTOR
MAURICE KIRBY
ADDRESS
DEC, 2 8, 1962 mache
Received and filed Varken it ..........
X PLACE OF DEATH No. TIRRELL E., HEN ().irst Name) ( Middle Name ) (last Name) (If deceased is a married, widowrd or divorced woman, kive also maiden name.)
2 FULL NAME
(a) Residence No. (('sual place of abode)
Length of stay : In place of death
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
12
(Month)
(1)as)
(Year)
4|HEREBY
12/26 . 116
1
CERTIFY,
2
1
That I attended deceased from
26
I last saw he alive.on 1 2/ 26 19 .. ₺ .. 3, death is said to have occurred on the date stated above, at. 9.4A.m.
INTERVAL BETWEEN ONSET AND DEATH
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
ACUTE PULMONARY EDEMA
(a)
Due To (b) A.S. N.D.
arterio sclerotic heart diseaseation:
Due To MYOCARDIAL INFARCT (c)
OTHER SIGNIFICANT CONDITIONS
..
Was autopsy performed>
No
What test confirmed diagnosis?
No
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
ThomasJ. Connally
M. D
(State or country)
M.55
THOMAS S. CONNolly
PRINT OR TYPE SIGNATURE)
-
on cates, and . Acts of res Physi- ntor type signature.
4.5.
25 1963
.
FICATE
EATH ter one :ach nd (c) "t mean dying. failure, ! means compli- caused
j any, rise to (0). under. last. contrib- but not terminal on given .
HATERIC.
apter 137% 1. requires to print or cause or death
PARENTS
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mil ALICE
TIPRELL
21
Informant
(Address)
234 SHAUNE DRIE HINTHRIA
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with, me BEFORE the burial or transit permis was issued: RK orman (Signature of Agent of Board of Health of other) 14407 12/26/62 X
(Official Designation)
(Date of Issue of Permit)
NS
23# short DR.
months
. & days. In place of residence & hadean.
2 6 6 2
A TRUE COPY ATTEST:
Charles H. Mackie City Registrar
7
FED : 51063 AM
R-303 burial permit a of Health UAgent.
of Death. See reverse side for additional information. See also Chap. 38, §§ 6, 20; Chap. 46, §§ 9. 10; Chap. 114, DEATH in plain terms, so that it may be properly classified under the International Classification of Causes Information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MARALA VI
§§ 44-48.
40M-9-61-931348
PLACE OF DEATH
SUFFOLK
1
(County)
BOSTON
(City of Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
OUT - OF - TOWN
(City or Town making this return )
Registered No.
1.28.63
En route to East Boston Relief Station
f(If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
JOHN J. USSEGLIO
( First Name)
( Middle Name)
(Last Name)
[ (Was deceased a
U. S. War Veteran.
lif so specify WAR)
( If deceased is a married, widowed or divorced woman, give also maiden name.)
St.
Winthrop, Massachusetts
(a) Residence. No.
( l'sual place of abode)
Length of stay: In place of death
years ...
... months
days. In place of residence .
14
years.
.. months ...
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
J DATE OF
DEATH
December 31. 1962
(Month)
(Day)
(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.) Arteriosclerotic heart disease, Coronary occlusion.
5 Accident, suicide, or homicide (specify) Date and hour of injury 19.
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
public 1dace ?
(Specify type of place)
Manner of Injury
(How did injury occur ?)
Nature of Injury
While at work ?
Was aumusy performed?\No.
6 Was disease or injury in any way related to occupation of deceased?
(Signedy Miongel A. Luongo, D
(Print or Thpe Xa
12/31 19.62
7
Winthrop Cemetery, Winthrop Place of Burial, or Cremation,
(City or Town)
DATE OF BURIAL January 4th ,63
8 NAME OF FUNERAL DIRECTOR Richard C. Kirby, Inc 917 Bennington St. , E. Boston
JAN 3, 1963 . 19
Received
........
A TRUIE COPY ATTEST.
( Registrar)
9 SEX
10 COLOR
(write the word )
Male
White
11 SINGLE
MARRIED
WIDOWED
DIVORCED
Married
UNKNOWN
12 If married, widowed, or divorced
theresa V. Cavagnaro
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full) Dec.27,1898
13 DATE OF BIRTH
14 AGE. 64 Years
4
Mont
Days
If under 24 hours .Hours Minutes
15 Usual
Occupation
Painter-retired
( Kind ( work done during most of working life)
16 Industry or Business
Painting
17 Social Security No.
031-09-3793
18 BIRTHPLACE (City) (StNe or country ) Mass.
19 NAME OF
FATHER
Joseph Usseglio
20 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
21 MAIDEN NAME
OF MOTHER
Aurelia Morello
22 BIRTHPLACE OF MOTHER (City) (State or country) Italy
23 Mrs. Theresa V. Usseglio-wife Informant (Address) 78 Marshall St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: R. K. Harman gt
(Signature of Agent of Board of Health or other)
14494
1/2/63
(Official Designation)
(Date of Issue of Permit)
-
PARENTS
M. D.
(Address) Boston
Date
-
D .- Wn.IL.
$ 25.1983
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
250
78 Marshall Street
(If nonresident, give city or town and State)
O
Boston
A TRUE COPY ATTEST: Charles it Mackie City Registrar
-
FED :5163 AM
4744
ம் .
. .
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