USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1962 > Part 6
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DATE OF ENTERING MILITARY SERVICE, TOWA
DATE OF DISCHARGE
RANK, RATING NilF
ORGANIZATION AND OUTFIT
8
5 ..
SERVICE NUMBER M'INTY
6
LERK
FEB 191962 AM
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.
IM R-301A 1
Shirky ST
N RUCTIONS FOR
CERTIFICATE C
giving S. OF DEATH ciot enter o than one u for each 1. (b) and (c)
Des not mean me of dying, a heart failure, in etc. It means Me, or compli- which caused
Hims, if any, chave rise to e cause (a), the under- cause last.
mations contrib- foleath but not the terminal ndition given
te Chapter 137, 01954. requires .tens to print or e cause or em of death on "tificates, and ote 48. Acts of , quires Physi- st print or type vier signature.
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City of 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.
f(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.) 142 Pleasant Street
(a) Residence. No.
( L'sual place of abode)
Length of stay: In place of death ..
.years.
5
.months.
days.
In place of residence.
. . years.
32
months .........
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
FE b.
20
(Month)
(Day)
1962. (Year)
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
Larrë
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
DEE
56
to ... y.
7 € bruary 20 1962
I last saw hi Walive on
have occurred on the date stated above, at.
2:00 A.m.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Coronary Seclusion acute
INTERVAL BETWEEN ONSET AND DEATH 1/2 hour
Due X
(b)
Arterio selerotic Heart Disco
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
None.
Was autopsy performed?
No
What test confirmed diagnosi
Clinical
5 Was disease or injury in any way related to occupation of deceased? No If so, specify
(Signed)
CHARLES LIBERMAN
(PRINT OR TYPE SIGNATURE)
(Addr WINTHROP, MASS Date ...
2/20/1962
6
Woodlawn
Everett
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
Feb. 23
62
19
7 NAME OF
FUNERAL DIRECTOR
Howard S Reynolds
ADDRESS
Winthrop, L'ass
Received and filed
FEB 21 1962
19
(Registrar)
PARENTS
10a If married, widowed, or div
HUSBAND of
55ssan Card
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
,12
AGE 80
Years ...
8
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Electrican <-- >
(Kind of work done during most of working life)
14 Industry
or Business :
Contractor
15 Social Security No. 010-07-1890
16 BIRTHPLACE (City)
(State or country)
Scotland
17 NAME OF
FATHER
James licol
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
19 MAIDEN NAME
OF MOTHER
L'anuilla Colledge
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
L'anuilla Moore
21
Informant
(Address)
North Reading, Lass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Talah Seremon ,
(Signature of Agent of Board of Health or other)
Health Offices
I. f. 21, 1962
(Official Designation)
(Date of Issue of Permit)
5-6928145
Winthrop Convale sent Home No.
2 FULL NAME
"Tilliam C Nicol (First Name) (Middle Name) (Last Name)
St.
(If nonresident, give city or town and State)
PERSONAL AND STATISTICAL PARTICULARS
Feb. 18 19 62, death is said to
6yrs.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER RECEIVED
TOWN
OFFICE O
11 17
10
CLERK
MII:
9
!!!!
*
5
6
IT
HROPM
FEB 2 11962 PM
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.
4 R-301A 1
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
bes not mean be of dying, o heart failure, o etc. It means e, or compli- which caused
ns, if any, ave rise to cause (a), the under- ause last.
w'ions contrib- 'o'eath but not the terminal adition given
te Chapter 137, 01954, requires ic ns to print or e cause or es of death on rtificates, and te 48, Acts of quires Physi- 3 t print or type : uler signature.
5-6)28145
PLACE OF DEATH
Suffolk (County)
I Mal PETIT
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.
25
Registered No.
f(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Julius.
(First Name)
(Middle Name)
(Last Name)
Lank
[ (Was deceased a U. S. War Veteran,
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
11 Pearl Avenue
(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
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
Married
OF DIVORCED
10a If married, widowed, or divorced Mazil Brenner
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
59
Years ..
Months.
.Days
If under 24 hours
Hours.
Minutes
13 Usual
machine Invester
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business :
General Electric Co.
15 Social Security No. 001-65-8398
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
Barnett Kank
18 BIRTHPLACE OF
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Bessie ( AZ)
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
21 Informant Maxa Rank
(Address) il PianRau denchien
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)
2/13/62
(Official Designation)
(Date of Issue of Permit)
VIBV
3 DATE OF
DEATH
Feb.
22
1962
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
That I attended deceased from
1962
to ...
Sept
50
Feb
22
I last saw h.în alive on
Feb. 22
.......
1962, death is said to
have occurred on the date stated above, at 1:15 A.m.
INTERVAL
BETWEEN
ONSET AND
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) Cerebral Hemorrhage
DEATH
Due
(b)
Hypertension
yours.
Due To
(c)
Arteriosclerosis
4 yrs.
OTHER
Residual of Cerebral
CONDITIONS
Hemorrhage
5475
Was autopsy performed?
What test confirmed diagnosis? Clinical
5 Was disease or injury in any way related to occupation of deceased? If so, specify
No
(Signed)
Charles Liberan
M. D
CHARLES LIBERMAN
(PRINT OR TYPE SIGNATURE)/
(Address
WINTHROP, MASS Date 2/22/1962.
6
Jiferah breach of Winetrop Everest
(City or Town)
Place of Burial or Cremation
Feb 23
1962
DATE OF BURIAL
7 NAME OF
DIRECT Jork Jurnal desiree Trec
ADDRESS Chelsea -
Received and filed
FEB 23-1962
.. 19.
(Registrar)
PARENTS
St.
(If nonresident, give city or town and State)
1
if so specify WAR)
No
1
No. Winthrop Community Hospital
SPACE FOR ADDITIONAL INFORMATION).
DATE OF ENTERING MILITARY SERVICE
OF
DATE OF DISCHARGE 1.12
10
RANK, RATING -
LERK
19. ORGANIZATION AND OUTFIT
SERVICE NUMBER
6 ..
NTHROP.
FEB 2 31962 AM
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.
BIR-303
DEATH in plain terms, so that it may be properly classified under the International Classification of Causes SuppILU. MLUICAL LAAMINEKS should state CAUSE AND MANNER OF N B .- WRITE PIAINI.Y WITH !INFARINA BYLADIE of Death. See reverse side for additional information. See also Chap. 38, §§ 6, 20; Chap. 46, §§ 9, 10; Chap. 114,
§§ 44-48.
50M - 3-61-930213
PLACE OF DEATH
SUFFOLK (County) WINTHROP (City or Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or its Agent.
Registered No.
220 Veterans Road
S(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) No.
2 FULL NAME
SAMUEL
NESSELLE
PHYSICIAN - IMPORTANT
[( Was deceased a
(First Name)
(Middle Name)
(Last Name)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
30 Cutler Street
St.
Winthrop, Massachusetts
(a) Residence. No.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ..
.years. ... ..
.... months.
days.
In place of residence.
2.5years
.months ........
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
February 22, 1962
DEATH
(Month)
(Day)
(Year)
9 SEX Male
10 COLOR
White
11 CITIZEN
OF U.S.
YES
NO
12 SINGLE MARRIED 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 ARTERY DISEASE
12a If married, widowednor divorced ringer HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
13 DATE OF BIRTH
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 in
public place ?
(Specify type of place)
Manner of Injury
(How did injury occur?)
Nature of Injury
While at work ? Was aurysy
6 Was disease or injury in any way related to occupation . deceased ?.
If so, specify
(Signed) Leonard Atkins M.D.
(Print or Type
(Address) 25 Shattuck St. Date 2/22 62 19
Beth Joseph #3, Woburn 7
Place of Burial, or Cremation. (City or Town)
DATE OF BURIAL
February 23, 1962
8 NAME OF
FUNERAL DIRECTOR
Benjamin Birnbach
10 Washington St. Dorch.
ADDRESS
Received and filed FEB 23 1962 19
14
AGE.
56 Years ...
..........
.. Days
If under 24 hours Hours Minutes
15 Usual Occupation
PDumber
(Kind of work done during most of working life)
16 Industry on Business. a f ..... Employed
17 Sockel Security No. ....... 010-05-7554
18 BIRTHPLACE (City)
(State or country)
Boston, MaEs
19 NAME OF
FATHER
David Nesselle
20 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
21 MAIDEN NAME OF MOTHER Gertrude Medson
22 BIRTHPLACE OF MOTHER (City) (State or country)
Russia
23 Anne Nesselle
Informant
(Address)
30 Cutler 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)
2/23/67
(Official Designation)
(Date of Issue of Permit)
A TRUE COPY ATTEST: (Registrar)
PARENTS
, M. D.
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
X 1
1
U. S. War Veteran,
[if so specify WAR)
Ne
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
TOM
ORGANIZATION AND OUTFIT
SERVICE NUMBER
.1
ERK
6
2
TROP. MA
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice:
(1) Attending physicians Enl gettify toAsuch deaths only as those of persons to whom they have given bedside care during a last illness from disease drfrelated 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
PLACE OF DEATH
Suffolk (County)
Winthrop (City of 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.
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 Veteran,
lif so specify WAR)
no
(1f deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.160 .WebsterSt
(U'sual place of abode)
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 SEXF
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
10a If married, widowed, or divorced
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
.Years ...
.......
Months.
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
none
(Kind of work done during most of working life)
14 Industry
or Business :
none
15 Social Security No.
none
16 BIRTHPLACE (City)
(State or country)
Winthrop, Mass.
17 NAME OF
FATHER
Edward Bagnera
18 BIRTHPLACE OF
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Margaret DiNocco
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston, Mass.
21 Edward Bagnera (father)
Informant
(Address)
160 Webster St & Boston 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)
2/27/62
(Official Designation)
(Date of Issue of Permit)
1
-
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Prematurity
Due To
(b)
Premature separation of
Due To
(c)
Placenta
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
No
What test confirmed diagnosis?
None
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
D. Thomas Stoffer
M. D
D. Thomas STAFFHIER
(PRINT OR TYPE SIGNATURE)
(Address)
JI BREEAST
Date: FEB. 24 19 62
Holy Cross Cemetery
Malden
Place of Burial or Cremation
Feb. 27,
19.
7 NAME OF
FUNERAL
DIRECTOR
Vincent Kapino
9 Chelsea St., Last Boston, Mass.
ADDRESS
Received and filed 2-27 1962
(Registrar)
PARENTS
Bagnera
2 FULL NAME
V: RUCTIONS FOR CI CERTIFICATE
] giving SJOF DEATH
o ot enter al than one u for each a (b) and (c)
s Does not mean The of dying, as heart failure, ia etc. It means ste, or compli- s which caused
dins, if any, chave rise to e cause (a), inthe under- grause last.
ontions contrib- to'eath but not " the terminal ndition given
te Chapter 137, 01954. requires sic ns to print or e cause or es of death on hertificates, and pte 48. Acts of , nuires Physi- st print or type e vier signature.
6-6928145
Winthrop Community Hospital No. Female (First Name) (Middle Name)
(Last Name)
St
East Boston
(1f nonresident, give city or town and State)
3 DATE OF
DEATH
February 24, 1962
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Feb 24
,52
to
Feb. 24
19
62
I last saw h
.... hive on
Feb. 24
19 62
death is said to
have occurred on the date stated above, at
INTERVAL
BETWEEN
ONSET AND
8:50Am.
DEATH
5.7-66
6
DATE OF BURIAL
(City or Town) 62
Winthrop, Mass.
F1 R-301A 1
HRS.
1
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
RECEIVED
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
6
THROP.
RULES OF PRACTICE
FEB 2 71962 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.
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
IX Suffolk (County)
3,4313V
LENSE PETIT
Winthrop
(City or Town)
No. Winthrop Community Hospital
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.
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