USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1963 > Part 21
Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54
CONDI
1958; angina Pectoris
Was autopsy performed?
What test confirmed diagnosis ?
Ecq
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify
NO
(Signature)
4. B. herenfiets
M. D.
H.B. Greenfield
747 Shirley S( Print or Type Name) WinthropMas
(Address)
Date.
5-21
1963
6 Winthrop
Winthrop
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
May 24.
.19.63
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
Winthrop Mass.
ADDRESS
Received and filed
MAY 23 1963
19
I
Winthrop .... (City or Town)
No .......
Town .... Hall ..... Winthrop
PHYSICIAN - IMPORTANT
(Was deceased a
no
U. S. War Veteran,
if so specify WAR).
St
(If nonresident, give city or town and State)
T OR TYPE OR CAUSES DEATH not enter e than one se for each , (b) and (c)
does not mean de of dying, heart foilure, , etc. It meons ase, or compli- which caused
tions, if ony, gove rise to couse (0), & the under- couse last.
iditions contrib- › deoth but not to the terminal condition given
PIN
42-932382
(Registrar )| (Official Designation)/ .
BIRTH CENTI do FILE LIST. REMENT
PARENTS
031-09-9236
Myocardial infarction
ORM R-301
for burial permit oard of Health its Agent. TRUCTIONS FOR L CERTIFICATE
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.
(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.
ORM R-301
for burial permit bard of Health its Agent. RUCTIONS FOR . CERTIFICATE
· OR TYPE OR CAUSES DEATH not enter than one e for each (b) and (c)
does not mean de of dying, heart failure, etc. It means ase, or compli- which caused
ions, if any, gave rise to cause (a), the under- cause last.
ditions contrib- death but not 'o the terminal condition given
22-932382
A TRUE COPY ATTEST:
:
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
Female White
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
(write the word)
Single
11 If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12
AGE
74 Years.
Months ...
.. Days
If under 24 hours
Hours ..
Minutes
13 Usual
Occupation :.
HouseWORK
(Kind of work done during most working life)
14 Industry
or Business :
OWN Home
15 Social Security No ....
028-05-9768
16 BIRTHPLACE (City)
(State or country )
CANADA
17 NAME OF
FATHER
Joseph Hale
18 BIRTHPLACE OF
FATHER (City)
(State or country)
CANADA
19 MAIDEN NAME
OF MOTHER
MARY Shermany
20 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
CANADA
Rita Heil
21 Informant
(Address)
67 Wordsworth St. E. Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
26.0.
(Signature of Agent of Board of Health or other) June 1, 1963
(Date of Issue of Permit)
1
Winthrop
(City or Town)
Winthrop Community Hospital
S(If death occurred in a hospital or institution,
St. Į give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
67 Wordsworth Street
East Boston,
Mass.
(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 .......... years .......... months .......... days.
3 DATE OF
DEATH
MAY
31-
1963
(Month)
(Day)
(Year)
4 IHEREBY CERTIFY
, That I attended deceased from
3
1963
I last saw h& ... alive on
MAY
31
to ...
MAY
1963
death is said to
have occurred on the date stated above, at
..... m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Cerebro vascular accident
INTERVAL BETWEEN ONSET AND DEATH 2 weeks
17yrs
Due To (c)
OTHER
Theft leg amputate que le
CONDITIONS
arterial thrombosis 1961
Was autopsy performed?
110
What test confirmed diagnosis ?
Clinical
5 Was disease or injury in any way related to occupation of deceased ?
If so, specify
110
(Signature)
Charles meloni MD
M. D.
CHARLES MELONI
(Print or Type Name)
(Address)
305 Haurest EBosto Date.
NA4.31,63
Holy Cross 6
Malden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
June
3
1963
7 NAME OF
. DIRECT
TRelleRICK J. MAGRATH
ADDRESS
EAST Boston
Received and filed
JUN 5 1963
19
CENSE PETITS
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS OVIETEM STANDARD
CERTIFICATE OF DEATH
Registered No.
C
No ..
Piston 6-6-63
X PLACE OF DEATH
Suffolk -
(County)
(City or Town making this return)
Mary Hale
(Was deceased a
U. S. War Veteran,
(if so specify WAR).
No
St
4
(Registrar) | (Official Designation)
X
PARENTS
(b) Due ToGeneral arteriosclerosis
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE
RECEIVED 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.
OF TOW
17 12
(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 Labsent from home when the certificate of death is needed.
1000
1330
CO
5
6
(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.
WINTHROP
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
JUN : 51963 9Nement of Occupation .- Precise statement of occupation is very impor- Yant, 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
d for burial permit Board of Health its Agent. STRUCTIONS FOR AL CERTIFICATE
IT OR TYPE OR CAUSES F DEATH
not enter re than one se for each ). (b) and (c)
does mot medm sode of dying, s heart failure. a, etc. It means ease, or compli- which comsed
litions, if amy, & gove rise to e comse (a), ng the under- cause last.
onditions contrib- to death but mot to the terminal condition given
153.8 47. X7/
8 - 1983
1-62-932382
PLACE OF DEATH
X LUT Suffolk (County) East Besten (City or Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No. 1
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,
il so specify WARI
No
(a) Residence. No. 37 Mermaid Ave.
(Usual place ol abode)
Length of stay : In place of death .......... years ....
"{ .. months .......... days. In place of residence .. O.years. ......... months .......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
22
1963
(Month)
(Day)
(Year)
I HEREBY CERTIFY , That I attended deceased Irom 19. ,50 63 Cet. 19 ..
I last saw he blive on
April
22 1) 63
death is said to
have occurred on the date stated above, at
5:30 P.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Carcinoma
of Colon
Due
(b)
with generalized
Due To
carcinomatosis, especially
(c)
to liver
OTHER
SIGNIFICANT
CONDITIONS
None.
Was autopsy performed ?
No
What test confirmed diagnosi
Operative-Pathological.
5 Was disease or injury in any way related to occupation of deceased ? Il so, specily ...
(Signature)
Charter Liberman.
CHARLES LIBERMAN
(Print or Type Name)
(Address) WINTHROP, DASS Date.
4/23/1963
6 Tiferath Israel of Winthrop EverETT
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 23
1963
7 NAME OF
FUNERAL DIRECTOR
Arnold Golov
ADDRESS 1668 Beacon ST. Brockline
Recepred and filed
APR 2.4 1963
Charles it Mackie
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
white
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
(write the word)
widowerl
11 If married, widowed, or divorced HUSBAND ol
(Give maiden name of wile in full)
(or) WIFE of
Joseph Kalish
(Husband's name in full)
12
AGF 62 Years.
.Months.
.. Days
If under 24 hours
Hours ........ Minutes
13 l'sual
Occupation :
Housewife
( Kind of work done during most working life)
14 Industry
or Business :
AT Home
15 Social Security No ..
None
16 BIRTHPLACE (City)
(State or country)
Russia
17 NAME OF
FATHER
Levi Golden
18 BIRTHPLACE OF
FATIIER (City) ..
(State or country)
Russia
19 MAIDEN NAME
OF MOTHER
CNBL
20 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
Russia
Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death hled with me BEFORE the bug l or 'transit permit was issued:
Signature of Agent of Board of Healthor other) /
16338
11/13/63
(Date of Issue of Permit)
V.
A TRUE COPY ATTEST:
......
St Winthrop
(If nonresident, give city or town and State)
2 FULL NAME
Eva (Golden) Kalish
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(City or Town making this return)
1
Princeton Shelby Nursing Home
103
PARENTS
Myer Press, 35 Mermaid
21 Informant
( Address)
(Registrar)|| (Official Designation)
-
4
to ...
April 22
INTERVAL BETWEEN ONSET AND DEATH 6yrs.
RECEIVED
TOWN
0
OFFICE
NIN
GLERK
W
ROP. MASS.
JULI 8 1963 AM
City Registrer
Charles H. Mackie
AUF) ONLY ATTESTI
X SUFFOLK. (County)
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)
04828
Registered No.
[(If death occurred in a hospital or institution,
.St. { give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
JOSEPH BRENDEN SHEA
(Il deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
35 SIREN ST
(Usual place ol abode)
Length of stay: In place ol death ........
.years.
2
months.
......
days. In place of residence 33 years.
........ months .......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
May
4
1963
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY
an
19
to ...
63
May 4
19.63
I last saw hondlive on
may
05, 1963, death is said to
have occurred on the date stated above, at
5A m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
CEREBRO VASCULAR ACCIDENT
INTERVAL BETWEEN ONSET AND DEATH 3 mos
Due
ARTERIO SCLEROSIS
(b)
Due To (c)
OTHER
DIABETES MELLITUS YOU
SIGNIFICANT
CONDITIONS
DUODENAL ULCER JO
Was autopsy performed ?
No
What test confirmed diagnosis ?
5 Was disease or injury in any way related to occupation ol deceased ? If so, specily .....
No
(Signature)
Johnadams fr R
M. D.
1JOHY
ADAMS
(Print or Type Name) (Address) 704 HUNTINGTON AtDate.
5/4
19.
63
6 NEW CALVERY
BOSTON
Place of Burial or Cremayon
(City or Town)
DATE OF BURIAL MAY 1 16 3
7 NAME OF
FUNERAL DIRECTOR
MAURICE W KIRBY.
ADDRESS WINTHROP,
Received and fled
MAY 8 1963
Charles ? Mackie ( 6)}]
11/11/19631
( Registrar )|| (Official Designation)
(Date of lsue of Permit)
V.I.V
A TRUE COPY ATTEST:
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
MALE
9 COLOR
WHITE
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
(write the word)
WIDOWED
11 If married, widowed, or divorced
HUSBAND of CATHERINE
HURLEY
(Give maiden name of wile in fun)
(or) WIFE of ...
( Husband's name in full)
12
AGE. 76 Years.
Months.
.... Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
MANAGER
( Kind of work done during most working lile)
14 Industry
or Business:
FIRST NAT STORES
15 Social Security No 028-05-3878
IRELAND
16 BIRTHPLACE (City)
(State or country )
17 NAME OF
FATHER
MICHAEL SHEA.
18 BIRTHPLACE OF
FATHER (City)
IRELAND
(State or country)
19 MAIDEN NAME
OF MOTHER
MARY FLAYHIVE
20 BIRTHPLACE OF
MOTHER (City).
(State or country)
IRELAND.
21 Informant
MISS, MARY R. SHEA
( Address)
35 SIREN ST WINTHROP MASS
I HEREBY CERTIFY that a satisfactory standard certifcate of death was hled with me BEFORE the burial or transit permit was issued: 1
1
1,2-932382
PLACE OF DEATH
d for burial permit loard of Health its Agent. TRUCTIONS FOR IL CERTIFICATE
T OR TYPE OR CAUSES DEATH not enter e than one e for each , (b) and (c)
does not mean ode of dying, heart failure, , etc. It means case, or compli- which caused
itions, if any, gave rise to :cause (a), & the under- cause last.
sditions contrib- , death but mot to the terminal condition given
331
1. 9-1963
1
BOSTON
(City or Town)
BARKER HILL HED, CENTRE N
St
(Was deceased a
U. S. War Veteran,
il so specily WARY
No
WINTHROP
(Il nonresident, give city or town and State)
----
(a)
FORM R-301
PARENTS
(Signature of Agent of Board of Health or other)
BOSTON
That I attended deceased from
A TRUE COPY ATTEST:
Charles It. Mackie City Registrar
KERK
..
0
THROP
JUL - 91963 AM
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 mat mean de of dying, heart failure, etc. It means ase, or campli- which caused
tions, if any, rave rise to cause (a), : the under- cause last.
ditians contrib- death but mat to the terminal condition given
260 63
I Director luse only i.K Ink. 9- 1963
·2-932382
PLACE OF DEATH
(County)
1
BOSTON
(City or Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
[(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME.
Loretta Thompson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
-
(Was deceased a
U. S. War Veteran,
if so specify WARY
No
(a)
Residence. No.
142 Pleasant St.
.. St
Winthrop
Mass.
(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 ......... years .......... months .....
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
Female White
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOW
Vilaved
4 I HEREBY CERTIFY,
That He attended deceased from
19
April 24
63
May 5,
to,
We I last saw h ...... alive on
May .... 5,
19.
63 death is said to
have occurred on the date stated above, at 6 ... am ......... m.
(or) WIFE
(Givy maiden name of wife in full)
HENRY U. THOMPSON
(Husband's name in full)
12
AGE/
75 Years.
Months.
.. Days
lf under 24 hours
Hours .. .... Minutes
13 Usual
Occupation :
Housework
(Kind of work done during most working life)
14 Industry
or Business :
OWN Home
15 Social Security No CNBL
16 BIRTHPLACE (City) SQUANTUM
(State or country)
MASS
17 NAME OF
FATHER
Joshua C. Small
18 BIRTHPLACE OF
FATHER (City).
(State or country)
MAINE
19 MAIDEN NAME
OF MOTHER
CLARA TRACEY
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
News BRUNSWick
21 Informant
Avis CLARK
(Address) 10 HAVRe St. East Boston
I 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)
606752
5-6-63
(Date of Issue of Permit)
A TRUE COPY ATTESTI
5 Yrs
Due To
(c)
Thyroid
OTHER
Diabetes Mellitus
CONDITIONS
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)
M. D.
.Charles .. L .... Clay ... M. Da.
(Print or Type Name)
(Address) Aan's Dir .. Maas Gon'l. Hosp.
... Date
May 5, 63
Winthrop Winthrop
Place of Burial « Cremation
(City or Town)
DATE OF BURIAL
MAY 7
63
7 NAME OF
FUNERAL DIRECTOR RedeRICK J. MAGRATH
ADDRESS East Boston
MAY _8 1953
Received an hled
Charles A. Mackie
19.
11 If married, widowed, or divorced HUSBAND of
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Myxodma
INTERVAL
BETWEEN
ONSET AND
DEATH
5 Yrs
(a)
X SUFFOLKOF- TOWN
(City or Town making this return)
04866
NMASSACHUSETTS GENERAL HOSPITAL
...... ........
3 DATE OF
DEATH
May ... 5,
(Month)
(Day)
(Year)
1963
(write the word)
Due To
Idiopathic atrophy of
(b)
unk
Yrg
.....
PARENTS
(Registrar)|| (Official Designation)
A TRUE COPY ATTENT: Charles H. Fre ckie
JUL -91963 AM
ORM R-302
WRITE PLAINLY, WITH UNFADING BLACK INK OR USE APPROVED BLACK TYPEWRITER RIBBON - THIS IS A PERMANENT RECORD
m
Medical Examiner Waivere The Commonwealth of Massachusetts Jurisdiction
KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
Revere
(City or Town making this return)
COPY OF
Registered No.
CERTIFICATE OF DEATH Hospital [(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
Agnes Hodgkins (Finlayson)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
115 a Summit Ave.
St
Winthrop
(a)
Residence. No ..
(Usual place of abode)
1
... years .......... months .......... days.
MEDICAL CERTIFICATE OF DEATH
May
15,
1963
(Month)
(Day)
(Year)
4.1 HEREBY CER
TIFY,
That I attended deceased from
viay
V
te ...
May 15
63
death is said to
I last saw h ...... alive on
10:45A
have occurred on the date stated above, at
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Uremia
Due To
Cerebral thrombosis
lwk.
3yrs .
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
(write the word)
Widowed
11 If married, widowed, or divorced
HUSBAND of
Ralph (Giromigen namesof wife in full)
INTERVAL BETWEEN ONSET AND (or) WIFE of DEATH 12 hours . 86 1
14
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
(Kind of work done during most working life)
14 Industry
At home
or Business :
15 Social Security No2017
16 BIRTHPLACE (CiNew Brunswick, Canada (State or country)
17 NAME OF
FATHER
Murdock Finlayson
18 BIRTHPLACE OF
FATHER (City)
(State or country)
New Brunswick, Canada
19 MAIDEN NAME
OF MOTHER
Adeline Petley
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
"New Brunswick, Canada
Robert Hodgkins
21 Informant
(Address)
40 Taylor St., Winthrop
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
May
20,
063
DATE FILER
(Registrar of City or Town where deceased resided)
SOM - 10.61.931673
C.
PLACE OF DEATH'S
Suffolk
(County)
I
Revere
(City or Town)
Grover Manor
No ..
3 DATE OF DEATH (a) (b) 6 · resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town CONDITIONS
No
Was autopsy performed ?
Clinical signs
What test confirmed diagnosis ?
No
5 Was disease or injury in any way related to occupation of deceased ? ...... If so, specify James P. Burns
M. D.
5/15
63
(Address) ...... Everett.
Date
19
Winthrop Cemetery
Winthrop
I'lace of Burial or Cremation
May
18,
63
19.
DATE OF BURIAL
7 NAME OF
Ernest P. Caggiano
FUNERAL DIRECTOR
ADDRESS
147 Winthrop St. ,Win hrop
Received and filed
JUN 14 1963
19.
PERSONAL AND STATISTICAL PARTICULARS
(Husband's name in full)
AGE
Years
Housewife
OTHER
Left hemiplegia
SIGNIFICANT
Due To
Hypertensive heart
disease
(c)
19
.. ,
19
(If nonresident, give city or town and State)
Length of stay: In place of death .......... years .......... months.
.days. In place of residence.
40
(Was deceased a
U. S. War Veteran,
(if so specify WAR
T V. ....
PARENTS
(Signed)
537 Broadway
TAFEL OVIETEM
SPACE FOR ADDITIONAL INFORMATION DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE. RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
JUN 1 41063 AM
ORM R-302
WRITE PLAINI.Y, WITH UNFADING BLACK INK OR USE APPROVED BLACK TYPEWRITER RIBBON - THIS IS A PERMANENT RECORD
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town
at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased
resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
1
PLACE OF DEATH
Middlesex
(County)
OVIETEM
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
COPY OF CERTIFICATE OF DEATH
Registered No.
f(If death occurred in a hospital or institution,
....... St. ¿ give its NAME instead of street and number)
2 FULL NAME .....
ANNA L. CANAVAN
(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 ........
43 Hutchinson
(Usual place of abode)
.St ..... Winthrop.
Massachusetts
(If nonresident, give city or town and State)
Length of stay: In place of death.
5 years .6 months 15 days. In place of residence ...
... months ......... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
(write the word)
Single
4 I HEREBY CERTIFY , That I attended deceased from
163
Me ... 22.
...... ,
1963, to.
May22
I last saw hGaalive on
Hay 22
19 ... 633death is said to
have occurred on the date stated above, at ?......... m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
INTERVAL BETWEEN ONSET AND DEATH ?
12
AGE 74 Years.
7 Months.
2
Days
If under 24 hours
Hours .......
Minutes
Due To
(b)
Arteriosclorotic ..... Heart
Due To
(c)
........ Generalized Arteriosclerosis
14 Industry
or Business :
15 Social Security No ...
Cannot Icarn
Boston
16 BIRTHPLACE (City)
(State or country)
Marsachusetts
Was autopsy performed ?
no
What test confirmed diagnosis ?
clinical
5 Was disease or injury in any way related to occupation of deceased ? ..... o. If so, specify
(Signed)
M. D.
W.
Hanna
19 MAIDEN NAME
OF MOTHER
Emma L. Dubberley
20 BIRTHPLACE OF
Nova Scotia
MOTHER (City)
(State or country)
Canada
Holy Cross Cemetery
L'alden
....
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL May 25 19. 63
Waltham 54, Massachusetts
7 NAME OF
FUNERAL DIRECTOR
OMlilley .... Funderal .... Home
ADDRESS Winthrop, Leseschusetts
A TRUE COPY
ATTEST:
James J.
Carroll
(Registrar of City or Town where death occurred)
DATE FILED
May .... 27
16.3
.......
(Registrar of City or Town where deceased resided)
PARENTS
Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.