USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1963 > Part 31
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
None
Was autopsy performed?
What test confirmed diagnosis ? ....
ClinicaNo
5 Was disease or injury in any way related to occupation of deceased /3 If so, specify 7/7
(Signed),
CHARLES LIBERMAN
(PRINT QR TYPE SIGNATURE)
(Address)
WINTHROP,MASS Date.
8/4/1963
PARENTS
21
Informant
(Address)
Veronica Preg
15 Pleasant Park Rd
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Neph o Sirianni (B) (Signature of Agent of Board of Health or other)
Deseth Officer
Reggio 6, 19613
(Date of Issue of Permit)
1 X
1
151
PHYSICIAN - IMPORTANT [(Was deceased a U. S. War Veteran, [if so specify WAR)
:
ATE
TH
:
c) nean ying, lure, eans npli- used
y, to ), er- st.
trib- not ninal iven
137 ires It or or on and s of ysi- type ture.
86
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.
§(If death occurred in a hospital or institution,
St.
(If nonresident, give city or town and State)
(write the word)
Female
65
109:4
.3
Boston,
England
ADDRESS
(Official Designation)
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 dafe 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
SUFFOLK (County) Chelsea £9-92-8 CENSEPIT
The Commonwealth of Massachusetts KEVIN H. WHITE 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.
WINTHROP COMMUNTY HOSPITAL
St. Į give its NAME instead of street and number) No.
2 FULL NAME
FRANCES CARSTENSEN
(First Name)
(Middle Name)
(Last Name)
[(Was deceased a { U. S. War Veteran,
(if so specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
54 ELEANOR ST. CHELSEA
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ...
... years ...
months5 days. In place of residence 65 years.
........ months ...
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
....
(Morin)
CERTIFY
That I attended deceased from
192
I last saw he ffalive on
8
1963 death is said to
have occurred on the date stated above, at
6:55 a.m
INTERVAL
BETWEEN
ONSET AND
DEATH
8 SEX
9 COLOR
10 CITIZEN
OF U.S.
YES
NO
11 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
FEMALE
WHITE
11a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE,
Septicemia / Clinical
(a)
Due To
(b)
Due To
(c)
CholecysteCTOMY
Sall Stones
Hypertension
5 day
13
AGE 65 Years S.
Months /2 Days
, FE
14 Usual
Occupation :
HOUSE WORK
(Kind of work done during most of working life)
15 Industry
or Business :
OWN HOME
16 Social Security No. 031-34-1758
CHELSEA
17 BIRTHPLACE (City)
(State or country)
MASS.
18 NAME OF
FATHER
EDWARD CARSTENSEN
19 BIRTHPLACE OF
FATHER (City)
E, BOSTON
(Signed)
John H
(Print or Thpe Name)
0 Comm Ave . Date. Aug 5 .... 19.
Bosch
WOODLAWN
EVERETT (City or Town)
Place of Burial or Cremation
DATE OF BURIAL AU.E. D.
19.63
7 NAME OF
Mendel M. Deshimano
ADDRESS
2.
Gary ave. Chelsea
Received and filed
AUG 6 1963
19
PARENTS
1
20 MAIDEN NAME
OF MOTHER
MARIAN ELDER
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
MAINE
MRS. MARIAN FRANK
22
Infor mant
(Address)
5 COURTRAI WINTHROP
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Carph Es Sereanna (3)
(Signature of Agent of Board of Health or other)
Spaeth Officer
august 6,1963
(Official Designation) / (Date of Issue of Permit)
·X
:
CATE
ATH
e
h (c) mean ying, ilure, neans mpli- aused
ny, to a), er - ist.
ntrib- t not minal given
er 137, equires rint or se or ath on es, and Acts of Physi- or type nature.
01
1
WINTHILOP (City or Town)
Registered No.
152
....
S(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
(a) Residence. No.
(Usual place of abode)
AUGUST 5
(Day)
(Year)
1963
A TRUE COPY ATTEST:
(Registrar)
done
5 Was disease or injury) in any way related to ogeypation of deceased?
If so, specify
NO
John th Grande
Grandon
Blood cultures being
Was autopsy performed?
What test confirmed diagnosis?
Yes
OTHER SIGNIFICANT CONDITIONS
12 DATE OF BIRTI
APRIL 24, 1898
If under 24 hours
Hours .........
Minutes
·M. D.
(State or country)
MASS
6
-
4 I HEREBY
7-30
19.63.
to
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RECE VED
TO !!
OF
11.12. 1
.2
(MIN)
iv
ILERK
6.5
100
HROP
AUG 61963 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.
A
1
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.
Registered No.
153
[(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.
243 Winthrop Street 4/ Washington AVE
St.
(If nonresident, give city or town and State)
.. days. In place of residence4.0.
.. years.
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
August
11
1963
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY, NOV 195€ to ...
That I attended deceased from
August 11, 1963
10a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Edmind Thompson Roach
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE ... 7.1 Years.
Q .... Months
.2.7 .... Days
If under 24 hours
Hours ..........
.Minutes
13 Usual
Occupation :
housework
(Kind of work done during most of working life)
14 Industry
or Business :
own home
15 Social Security No.none.
16 BIRTHPLACE (City)
(State or country)
Erving
Massachusetts
17 NAME OF
FATHER
Charles F. Noyes
18 BIRTHPLACE OF
FATHER (City)
Jefferson
(State or country)
Maine
19 MAIDEN NAME
OF MOTHER
Josephine Clary
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Maine
Jefferson
6 Winthrop commentary, Winthrop, Mass.
Place of Burial or Cremation (City or Town)
August 13.1963 19
Informant
(Address)
Alstead, New Hampshire
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial .or transit permis was issued: Casper & fireanni (0)
(Signature of Agent of Board of Health or other)
Health officer Cuq 13,1963
(Date of Issue Of Permit)
TV. B. V
ATE
TH
c)
nean ing. lure, eans pli- used
y, 10 ), st.
trib- not tin al riven
137. ires it or or on and s of ysi- type ure.
86
× PLACE OF DEATH
Suffolk (County)
Bay View Nursing Home No. REACH.
2 FULL NAME ...
I(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
Length of stay : In place of death .. . ... years. 8 months :
8 SEX
Female
9 COLOR
White
10 SINGLE
(write the word)
MARRIED WIC Owed
WIDOWED
or DIVORCED
I last saw h.EX .. alive on
Aug. 11,1, 1963
death is said to
have occurred on the date stated above, at 11/2011 m.
INTERVAL
BETWEEN
ONSET AND
DEATH
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a) Cerebrovascular Occhision
(b) Due Cerebro Arterios clerosis
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed ?
200
What test confirmed diagnosis? Clinical
5 Was disease or injury in any way related to occupation of deceased ? A If so, specify ...........
(Signed) I. D. CHARLES LIBERMAN
(Address)
(PRINT OR TYPE SIGNATURE) WINTHROP 14055 Date. 8/11/163
7 NAME OF
FUNERAL, DIRECTOR
alfred B. March
ADDRESS
174 .winthropSt .... Winthrop, Mass.
Received and filed
August 1319 63
(Registrar)
(Official Designation)
Ralph E Roach
DATE OF BURIAL
PARENTS
3 yrs
Violet Estelle
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE DE DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICEN
NROD NETBER
AUC 1 31963 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.
-301
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
154
S(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
Amy
Gertrude
Hea rn
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
265 Newbury
(Usual place of abode)
Length of stay: In place of death .......... years.
6
... months .......... days. In place of residence.
.. years.
.. months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
F.
9 COLOR
W.
10 SINGLE
MARRIED
WIDOWED
DIVORCED
UNKNOWN
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
AGES 3
Years
4
Months 23 Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
NURse (Ret.)
(Kind of work done during most working life)
14 Industry
or Business:
Boston State Hosp
15 Social Security No.
16 BIRTHPLACE (City) ENglAnd (State or country)
17 NAME OF
FATHER
Rebun HearN
18 BIRTHPLACE OF
FATHER (City)
(State or country)
ENGLAND
19 MAIDEN NAME
OF MOTHER
CAROLINE J. Elkins
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
ENGLAND
William Hearn
21 Informant
( Address)
Clementsport, siLA SE.tin
I HEREBY CERTIFY that a satisfactory standard certificate of death was;fled with me BEFORE the burial or transit permit was issued: Mephisto Serianie(2)
...
(Signature of Agent of Board of Health or other) Der th, office
Curq. 13,963
( Registrar)| (Official Designation)
(Date of Issue of Permit)
1×
A TRUE COPY ATTEST:
1963 (Year)
4IHEREBY CERTIFY , That I attended deceased from
July 26
19 .. 6 ...
to August 12
I last saw hfralive on
August 12, 1963, death is said to
have occurred on the date stated above, at 5:10P.m.
INTERVAL
BETWEEN
ONSET AND
DEATH
(a)
f)ue To (b)
Due To (c)
Arteriosclerosis At.
3 yrs.
No
Was autopsy performed?
What test confirmed diagnosis ?
Charsal y Las
5 Was disease or injury in any way related to occupation of deceased ? ff If so, specify
(Signature)
M. Tranneseine dr. M. D. M. TRAUNSTEIN! VIR.M.D. (Print or Type Name) ! .
(Address)
AUG 12 1963
73 BARTLET 21 Win THROp FERNCliff COM. HARtsDAR, N.Y. Place of Burial or Cremation (City of Town)
DATE OF BURIAL August 12 19 63
7 NAME OF
FUNERAL DIRECTOR
JISWATERMANAJUNS
ADDRESS
Boston
Received and filed August 13, 1963
(City or Town making this return)
No. Bay View Nursing Home
·
1 permit calth
ATE
E SES
:
(c) nean ying, lure. eans npli- used
ty, 10 1), er- st. trib- ! not ninal given
PARENTS
Boston
St
(If nonresident, give city or town and State)
35-
3 DATE OF
DEATH
AUGUST
12
(Day)
(Month)
Postone
OTHER
SIGNIFICANT
CONDITIONS
DISEASE
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Bilateral Bronchopnsamonie IwK.
(write the word)
(Was deceased a
U. S. War Veteran,
(if so specify WAR)
No
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE.
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER.
RECEIVED
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.
OF
TOWN
OFFICE
11 12
10.
GLERA
11SE
CHRO
AUG 1 31963 PM
PLACE OF DEATH
Suffolk
I
(County) Winthrop
(City or Town)
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)
Sarah Ciccarelli (Marino)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No ..
67 Marshall
(Usual place of abode)
Length of stay: In place of death ..
3years ......... months ........
days. In place of residence 31
... years ..
... months.
... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
August
14.
1963
(Month)
(Day)
(Year)
4 IHEREBY CERTIFY , That I attended deceased from
19
to ..
19
I last saw h ...... alive on
19 ........ , death is said to
have occurred on the date stated above, at
1:10 Pm.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Death presumably due
(a)
Due
(b)
to natural causes
Due
(c)
probably acute coronary
SIGNIFOR Clusion on basil CONDITIONS clientey.
Was autopsy
What test confirmed diagnosis 2
Wuttrap Boardy Hurtig
5 Was disease or injury in any way related to occupation of fleceased ? If so, specify
(Signature)
Charles Liberman
, M. D.
Charles Liberman I. D.
(Print or Type Name)
(Address)
.Date
8/17
1969
......
6
Holy Cross Cemetery, Malden
Place of l'urial or Cremation
(City or Town)
August 17,
19.
DATE OF BURIAL
7 NAME OF
FUNERAL, DIRECTOR
Ernest P. Caggiano
147
winthrop st., winthrop
ADDRESS
Received and filed
AUG 16 1963
19
( Registrar)}
A TRUE COPY ATTEST:
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
female
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWEDmarried
DIVORCED
UNKNOWN
11 If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Richard Ciccarelli
(Husband's name in full)
12
70
11
13
If under 24 hours
Hours ........ Minutes
13 Usual
housewife
Occupation :
(Kind of work done during most working life)
14 Industry
CON
or Business :...
at home
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country )
Italy
17 NAME OF
FATHER
Flaminio Marino
18 BIRTHPLACE OF
FATHER (City)
(State or country) Italy
19 MAIDEN NAME
OF MOTHER Maria Grazia Savino
20 BIRTHPLACE OF MOTHER (City) (State or country) Italy
21 Informant
Robert Ciccarelli
( Address)
69 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:
(Signature.of Agent of Board of Health or other) Health ficar Quy 16,1963
(Official Designation)
(Date of Issue of Permit)
V.B
2
R-301
I permit ealth
CATE
PE SES
e h (c) mean lying, tilure, means mpli- aused
ny, to a), der - ast. ntrib- t not minal given
PARENTS
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
no
Winthrop
St
(If nonresident, give city or town and State)
2 FULL NAME.
Registered No.
155
No.
67 Marshall
63
INTERVAL
BETWEEN
ONSET AND
DEATH
AGE
Years
Months.
Days
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RULES OF PRACTICE
RECEIVED
TOW
10
Mill
2
CLERK
8
15
THROP NASS
AUG 1 61963 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 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)
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)
Registered No.
156
[(If death occurred in a hospital or institution,
St. ( give its NAME instead of street and number)
2 FULL NAME.
Charlotte (Walsh) .Tobin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
(if so specify WAR)
(a)
Residence. No ..
18 Haviland
St
Boston, .... Mass
(If nonresident, give city or town and State)
Length of stay: In place of death ........ years ......... months ... 6 days. In place of residence: 50 years
.months ..
.. days.
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.