USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1963 > Part 15
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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 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 dalls 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. ili
(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. 6
NTA AROtPhysicians: see explanatory instructions Statement of Cause of Death on face side of standard certificate of death.
Statement of Occullion. Fred@Statement of occupation is very import- ant, so that the relative healthfulness ofwaridas 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
SERVICE NUMBER
RM R-301A 1
nditions, if ony, ich gove rise to ve couse (0), ting the under- ng cause lost.
Conditions contrib- to death but not d to the terminol te condition given )
e .- Chapter 137, of 1954, requires c'ans to print or the cause
or s of death on certificates, and er 48, Acts of requires Physi- to print or type under signature.
M-11-59-926662
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.
20
[(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
2 FULL NAME
Catherine F. Crosby.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
20 Centre St.
St.
Winthrop
Length of stay: In place of death
5
.. years.
........... months .............. days. In place of residence ....
5 years months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
April
17
1963
DEATH
(Month)
(Day)
(Year)
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED Single
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY
-et
1963
to.
April 17
19
I last saw
Er alive on
April 17
19 63
death is said to
have occurred on the date stated above, at
1: 3 0 P. m.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
Bronchial
Pneumonia
INTERVAL
BETWEEN
ONSET AND
DEATH
10 days
11 IF STILLBORN, enter that fact here.
70
12
AGE
Years
Months.
Days
If under 24 hours
Hours ..
Minutes
13 Usual
Occupation :
Sorter (retired)
(Kind of work done during most of working life)
14 Industry
or Business :
Retired Laundry
15 Social Security No.
OII 05 9490
16 BIRTHPLACE (City)
(State or country)
Chelsea
Mass.
17 NAME OF
FATHER
Michael Crosby
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland®
19 MAIDEN NAME
OF MOTHER
Rose Ann Mckinnon
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Conn.
21 Informant (Address)
Ann Crosby 20 Centre St. Winthrop
(Sister)
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 20 63
19
7 NAME OF FUNERAL 325 Chelsea St. East Boston.
ADDRESS
Received and filed APR 2-3 1963 ....... ... 19 ..
(Registrar)
PARENTS
(Signed) Nathaniel P. Danoff M. I).
Nathaniel P Danoff
(PRINT OR TYPE SIGNATURE)
(Address) 37 Princeton St
Date .....
April 18 1963
6 Holy Cross
Malden.
Frederick J. Magrath.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or, transit permit was issued: triple E Leranni (?) ASignature of Agent of Board of Health or other) Health officer april 22, 1963
(Official Designation)
(Date of Issue of Permit)
TV
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
(a)
Due To Cerebral Vascular
(b)
accident
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
What test confirmed diagnosis ?
63
That I attended deceased from
(if so specify WAR)
(a) Residence. No.
(Usual place of abode)
PHYSICIAN - IMPORTANT
[(Was deceased a
U. S. War Veteran,
NO
(If nonresident, give city or town and State)
No.
20 Centre St.
FASE PETIT
To be filed for burial permit with Board of Health or its Agent.
NSTRUCTIONS FOR CAL CERTIFICATE
In giving SE OF DEATH do not enter ore than one use for each a), (b) and (c)
is does not mean mode of dying, as heart foilure, nia, etc. It means lisease, or compli- s which caused
5 Was disease or injury in any way related to occupation of deceased? If so, specify
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
5
-
RULES OF PRACTICE
IN
6
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 offlas the84963 AM 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.
FORM R-301
for burial permit Board of Health its Agent. TRUCTIONS FOR IL CERTIFICATE
T OR TYPE OR CAUSES DEATH not enter re than one se for each ), (b) and (c)
does not mean ode of dying, s heart failure, , etc. It means ease, or compli- which caused
itions, if any, k gave rise to e cause (a), og the under- cause last.
nditions contrib- o death but not to the terminal condition given
PLACE OF DEATH
Suffolk (County)
PasToro 5-7:63
LIBERTATE
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)
§(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 ....
34 A Bunker Hill St.
(Usual place of abode)
Charlestown, Mass.
St
(If nonresident, give city or town and State)
......... months ... ... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIEDC
WIDOWEISingle
DIVORCED
UNKNOWN
11 If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12
AG9.0
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 ...
None
16 BIRTHPLACE (City)
Charlestown
Mass
(State or country)
17 NAME OF
FATHER
Jeremiah Horrigan
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHEEllen Reardon
20 BIRTIIPLACE OF MOTHER (City) (State or country) Ireland
21 InformanNorman Horrigan
(Address)
150 Washington Ave., Winthro
I HEREBY CERTIFY that a satisfactory standard certificate of death was hled with me BEFORE the burial or transit permit was issued: faible & Jevrinne (3) ,(Signature of Agent of Board of Health or other) Health Officer iporel .20, 1/6/3
(Official Designation)
(Date of Issue of Permit)
TI
A TRUE COPY ATTEST:
5 yrs
Due To
(c)
arteriosclerosis
8 yrs
OTHER
Chronic bronchitis &
SIGNIFICANT
CONDITBUimonary emphysema 3 yrs
Was autopsy performed?
no
What test confirmed diagnosis? clinical & lab
5 Was disease or injury in any way related to occupation of deceased? no If so, spece
(Signature)
M. Traunstein N
M. D.
M.Traunstein Jr .... . M ... D.
(Address)
(Print or Type Name)
73 Bartlett Rd
4-20
19.63
6
Holy Cross
Malden, Mass
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 22 19
63
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
ADDRESS Winthrop .Mass.
Received and hled
APR 22 1963
19
(Registrar)
4 62-932382
1
Winthrop (City or Town)
No.
104 Highland Ave Mounts Nursing Home
Ellen ... E ....... Horrigan
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Length of stay: In place of death .. 4 years months ........ days. In place of residence 86, ears.
3 DATE OF
April 19, 1963
DEATH
(Month)
(Day)
(Year)
4 IHEREBY CERTIFY, That I attended deceased from
May 9
1958
to ..
April 19
196.3
:
I last saw @ .... alive on
April 15
196.3, death is said to
have occurred on the date stated above, at
.. 8 .:. 3.0.a.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Acutemyocardial infarction
INTERVAL BETWEEN ONSET AND DEATH 1 hr
Due To
(b) Arteriosclerotic ..... HD.
Generalized
PARENTS
6
Registered No.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
TO!
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
6
SERVICE NUMBER.
1
RI
APR 221963 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 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)
Mounts Nursing Home
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.
[(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)
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death.
2
years ....
months
.days. In place of residence.
......
... years.
months ..
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
19
1963
(Month)
(Day)
(Year)
That I attended deceased from
I last saw h ........ alive on
19
death is said to
have occurred on the date stated above, at
7:30 Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE Death presumably due to (a)
natural causes, probably Due To (b) @ cere brovascular occlusion On basis of past history. Due To
(c)
Winthrop Board of Health.
OTHER
SIGNIFICANT
CONDITIONS
Charles Liberman Mint
Was autopsy performed?
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify
(Signed) M D.
CHARLES LIBERMAN
(PRINT OR TYPE SIGNATURE)
(Addres
WINTHROP
Dat
4/19/
19
63
6HolyCross Cemetery
Malden
Place of Burial or Cremation
DATE OF BURIAL Monday , April ... 22, 1963 19 ..
(City or Town)
7 NAME OF
FUNERAL, DIRECTOR
CHESTER V. ZAKSHESKI
ADDRESS
79 Broadway - Chelsea
Received and filed APR 22-1963 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR
white
10 SINGLE
(write the word)
MARRIEIWidowed
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of ..... Margaret (Balon) GASKA
(Give maiden name of wife in fuli)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
69
AGE
Years.
Months ....
Days
If under 24 hours
.. Hours ...
Minutes
13 Usual
Occupation :
Laborer
(Kind of work done during most of working life)
14 Industry
or Business :
Bldg. - Wrecking trade
15 Social Security No. 015-18-3080
16 BIRTHPLACE (City)
(State or country)
Poland
17 NAME OF
FATHER
cannot be learned
Tu'da
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Poland
19 MAIDEN NAME
OF MOTHER
cannot be learned
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Poland
21 Laurel Shaughnessey
Informant (Address) 173 Shurtleff St Chelsea
I HIEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Kaiple É derauni 631
(Signature of Agent of Board of Health or other)
Zenith Office Cibul 22, 1463
(Official Designation)
(Date of Issue of Permit)
1 X
ISTRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH o not enter re than one use for each ), (b) and (c)
does not mean mode of dying, as heart failure, ia, etc. It means sease, or compli- which
caused
ditions, if any, ch gave rise to ce cause (a), ing the under- & cause last.
onditions contrib- to death but not I to the terminal condition given
::- Chapter 137, of 1954. requires cians to print or the cause or of death on certificates, and er 48, Acts of requires Physi- to print or type ander signature.
M1-6-59-925686
Chelsea 5-7-63
ČIMSE PETITE
No.
2 FULL NAME
Alexander STUNDZIO
(If deceased is a married, widowed or divorced woman, give also maiden name.)
6%- 3Rd ST
32 Spruce-St., Chelsea, Mass.
St.
4 I HEREBY CERTIFY, 19 ., to ... 19
INTERVAL
BETWEEN
ONSET AND
DEATH
PARENTS
Registered No.
IM R-301A 1
RECEIVED
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
OF TO!V;
LERK:
-31
1 ... 6.2
N
HROP
APR- 221963 MM
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.
ORM R-301
for burial permit oard of Health its Agent. TRUCTIONS FOR L CERTIFICATE
TOR TYPE OR CAUSES DEATH not enter e than one e for each , (b) and (c)
does not mean de of dying, heart failure, , etc. It means ase, or compli- which caused
tions, if any, gave rise to cause (a), { the under- cause last.
nditions contrib- o death but not to the terminal condition given
PLACE OF DEATH
Suffolk (County)
DERTA
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD
CERTIFICATE OF DEATH
Registered No.
73
[(If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Kenneth Morrill Godfrey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
16A. Wheelock Street
St
(If nonresident, give city or town and State)
months .......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
20
1963
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY , That I attended deceased from
Clone, 16, 19 63, to
Cipro 20
1963
I last saw h. @live on
Hp-VI 19, 196 death is said to
have occurred on the date stated above, at
2:20Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
myocardial
Heurt
DiscuJe
Due To
(b)
arteriosclerosis
Due To
(c)
Chrance Valuciler
OTHER
SIGNIFICANT
CONDITIONS
Heart Disease
Was autopsy performed?
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation of deceased . If so, specify
(Signature)
2 M. D. U JUSTAn GREGORIE
(Print or Type Name)
(Address) 194 Washington Date
7/10
19€
Winthrop Cemetery, Winthrop, Mass 6
Place of Burial or Cremation (City or Town)
DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
alfred 3 March
ADDRESS
174 Winthrop 'St. Winthrop,
Received and filed
APR 23 1963
19
(Registrar)|
A TRUE COPY ATTEST:
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
Married
male
white
II If married, widowed, or divorced
HUSBAND of
Vera Thorne Littlefield
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12
AGE6.7 ... Years .. ]. Q. . Months .. 1.3. Days
If under 24 hours
Hours ........ Minutes
13 Usual
retired guard
Occupation :
(Kind of work done during most working life)
14 Industry
or Business:
Mass. Institute of Tech.
15 Social Security No.
010-09-8908
16 BIRTHPLACE (City). (State or country) Mass
17 NAME OF FATHER Frank Warren Godfrey
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Wakefield
Mass.
19 MAIDEN NAME
OF MOTHER
Alice Morrill
20 BIRTHPLACE OF
MOTHER (City).
Melrose
(State or country)
Mass
Mrs. Kenneth M. Godfrey
16A. Wheelock St. Winthrop
Mas HEREBY CERTIFY that a satisfactory standard certificate of death was hled with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other)
Health Oficir
april 23 1963
(Official Designation) (Date of Issue of Permit)
T. V. K. V
-
Winthrop
(City or Town)
No
16 A. Wheelock Street
(Was deceased a U. S. War Veteran, (if so specify WAR) NO ..
(a)
Residence. No.
(Usual place of abode)
Length of stay: In place of death ....
w .. years ..
.. months
4 Days. In place of residence ......
40
(City or Town making this return)
PARENTS
April 23,1963
19
21 Informant
(Address)
Wakefield
400
eneralized
INTERVAL BETWEEN ONSET AND DEATH
52-932382
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. APR 2-21063ch deaths only as those of (2) Board of Health physicians will dertuyl 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.
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