Town of Winthrop : Record of Deaths 1963, Part 32

Author: Winthrop (Mass.)
Publication date: 1963
Publisher:
Number of Pages: 574


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1963 > Part 32


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


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


1


9 COLOR


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN


(write the word) Widowed


11 If married, widowed, or divorced


HUSBAND of


John


(Give maiden name of wife in full)


Tobin,


(or) WIFE of ..


(Husband's name in full)


12


AGE


101 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 :


AT HOME


15 Social Security No ..


NONE


16 BIRTHPLACE (City)


(State or country )


FRANKLIN, MASSI


17 NAME OF


FATHER


Walsh


18 BIRTHPLACE OF


CBL


FATHER (City)


(State or country)


19 MAIDEN NAME


OF MOTHER


CEL


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


CRL


Miss


CRANE


21 Informant


63 ( Address)


(Granddaughter) 1726 Esacon It.


Bricklings


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Ralph & Sirianni (3)


(Signature of Agent of Board of Health or other)


Health of five


august 16,1963


(Registrar) (Official Designation)


(Date of Issue of Permit)


X


A TRUE COPY ATTEST:


15


1963


(Month)


(Day)


(Year)


4 IHEREBY CERTIFY


That I attended deceased from


aug. 9


1963


to ..


aug


15


19


63


I last saw h .. Elalive on


aug


95, 1963, death is said to


have occurred on the date stated above, at


2:58 Pm.


INTERVAL


BETWEEN


ONSET AND


DEATH


Due To


(b)


arteriosclerosis


Due To


(c)


generalized


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed?


NO


What test confirmed diagnosis ?


5 Was disease or injury in any way related to occupation of deceased No


If so, specify


(Signa


res Papa Gregorio


M. D.


Joseph GREGORI


(Address)


(Print or; Type Name)


194 Washingtonand Date.


aug15 963


Ridgelawn Cemetery, Watertown 6


Place of Burial 01 ( fes


RigeLAWN (WATER TOWN)


DATE OF BURIAL


1 Mc Donald Funeral


NAME OF


FUNERAL DIRECTOR


McDonald Funeral !


f. Home


FRANK, & McDONALS)


401 COMMONWEALTHTAVO


ADDRESS


Received and filed


AUG 1.6. 1963


19


$2


R-301


1 permit Tealth


CATE


PE ISES


.


le :h ( c)


mean dying, ašlure, means ompli- caused


ny, : 10 (a), der- ast.


mtrib- it not minal given


1


8-26,63


No


Winthrop Community Hospital


PHYSICIAN - IMPORTANT


(Usual place of abode)


3 DATE OF


DEATH


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


myocardial Heart Disease


(a)


-


PARENTS


.


(City or Town)


August 17


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE.


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


RECEIVED


TO!


OF


1 1/ 12


19


LLERK .


5


6


IN


THROP M


AUG 1 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 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.


R-301


al permit Health t.


NS


FICATE


YPE USES H


er one ach d (c)


mean dying, failure, means compli- caused


any, se to (a), inder- last . contrib- but not erminal given


AMYLOIDOSIS OF


2 MOS.


Was autopsy performed ?


no


What test confirmed diagnosis ?


5 Was disease or injury in any way related to occupation of deceased ? no If so, specify


(Signature)


Louis 7. Salerno


M. D.


LOUISE SALERNO


(Address)


(Print or Type Name)


175 Pleasant Str


Plus 1 8 1963


6


WOODLAWN


EVERETT.


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


AUG 20


1963


7 NAME OF


FUNERAL DIRECTOR


MAURICE W KIRBY


ADDRESS


WINTHROP-


Received and filed


AUG 20 1963


19


( Registrar)


A TRUE COPY ATTEST:


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


9 COLOR


WHITE


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN


MARRIED


11 If married, widowed, or divorced


HUSBAND of


VIOLET


NEVINS


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


12


AGE 77 Years ...


Months.


Days


If under 24 hours


Hours . ... Minutes


13 Usual


Occupation :


BANKER


(RETIRED


(Kind of work done during most of iworking life)


14 Industry


or Business :


BANJY


15 Social Security_No ..


012-16-5819


16 BIRTHPLACE (City)


(State or country )


MYASS


17 NAME OF


FATHER


ALBERT E LOW


18 BIRTHPLACE OF


FATHER (City) .....


ESSEX 1


(State or country)


MASS


19 MAIDEN NAME


OF MOTHER


EMMA VENISON


20 BIRTHPLACE OF


MOTHER (City) ..


BOSTON


(State or country)


MASS


21 Informant


NIRS VIOLET LOW


(Address 200 BARTLETT RD WINTHROP.


I HEREBY CERTIFY that a satisfactory standard certificate of death was hled with me BEFORE the burial or transit permit was issued: Ralph /6. Seriamn (3) (Signature of Agent of Board of Health or other)


Health Otherin


Ciugust .20 1963


(Oficial Designation)


(Date of Issue of Permit)


TJB


104


X 1


PLACE OF DEATH


SUFFOLKT (County) WINTHROP. (City or Town)


The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD . QVIEL


CERTIFICATE OF DEATH


Registered No.


157


§(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) PHYSICIAN - IMPORTANT


2 FULL NAME


EVERETT R, LOW


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a)


Residence. No ...


200 BARTLETT PD


St


(Usual place of abode)


Length of stay: In place of death 50 years.


.. months .......... days. In place of residence: 30.


years


months ......


... days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


august 17 (Day)


1963 (Year)


(Month)


4 I HEREBY CERTIFY


That I attended deceased from


Jan 3 19.60 to ...! Cinquit M 63


I last saw hupalive on


august 17


19 ..... .. , death is said to


have occurred on the date stated above, at ....


2.39 Pm.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


CORONARY HEART DISEASE


INTERVAL BETWEEN ONSET AND DEATH


142


Due To


(b)


MYOCARDIAL INFARCTION


148


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


LARGE BOWEL


EAST BOSTON


PARENTS


(City or Town making this return,


No


200 BARTLETT PD


(Was deceased a


U. S. War Veteran,


(if so specify WAR).


(City or town and State)


(write the word)


MALE


2.3 ajeno


(a)


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE.


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


Or TO !!


10: " D


11


6" 1 %


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.


AUG 2 01963 AM


X


PLACE OF DEATH


Suffolk


62-92-8


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.


.158


[(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME


Baby Girl Gerardi


(If deceased is a married, widowed or divorced woman, give also maiden name.)


180 Waldemar Avenue


St


East Boston


(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


3 DATE OF


DEATH


August


19


1963


(Month)


(Day)


(Year)


19


4 IHEREBY CERTIFY , That I attended deceased fromfemale


KAULUST


1963


to ...


I last saw hC.falive on


19AUGUST


123 ... , death is said to


have occurred on the date stated above, at


1:40 Pm.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


PREMATURITY


INTERVAL


BETWEEN


ONSET AND


DEATH


3h.


Due To (b)


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed?


NO


What test confirmed diagnosis ?


5 Was disease or injury in any way related to occupation of deceased ?


If so, specify .


Labut Bornstein


(Signature)


(Print or Type Name)


Date


(Address)


190 PLEASANT ST


15 AUGUSTO 63


6


Holy Cross Cemetery


Malden


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


August 21


63


7 NAME OF


FUNERAL DIRECTOR


Vincent R. Kapino


ADDRESS


9 Chelsea Street, Cast Boston, Ma


Received and filed


AUG 20 1963


19


8 SEX


9 COLOR


white


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN Single


(write the word)


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.


Years ............ Months ...


Days


3


If under 24 hours


.Hours ....


Minutes


13 Usual


Occupation :


none


14 Industry


or Business :


****


15 Social Security No.


none


16 BIRTHPLACE (City)


(State or country)


Winthrop, Mass.


17 NAME OF


FATHER


John Gerardi


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Veronica. Rapino


20 BIRTHPLACE OF


MOTHER (City) ..


(State or country)


Boston


Mass.


John Yerardi (father)


21 Informant


(Address)


180 Waldemar Hve., East. Doston


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Kaiph & Liveanna (6)


(Signature of Agent of Board of Health or other)


Health officin


Cinqueto 20, 1963


(Registrar)|| (Official Designation)


(Date of Issue of Permit)


X


A TRUE COPY ATTEST:


382


R-301


rial permit Health ent. ONS


FICATE


TYPE AUSES H ter one ach nd (c)


ot mean dying, failure, t means compli- caused


f any, ise to (a), under- last.


contrib- but not terminal n given


1


(County)


Winthrop (City or Town)


No ..


Winthrop Community Hospital


(Was deceased a


U. S. War Veteran,


if so specify WAR)


no


(a) Residence. No ...


(Usual place of abode)


(a)


(Kind of work done during most working life)


PARENTS


WINTER!


M. D.


1


1


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE ROD


DATE OF DISCHARGE RANK, RATING


AUS .201963 PM


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.


X


A R-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


(City or Town making this return)


Registered No. 159


[(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)


2 FULL NAME


Helen Beattie


(If deceased is a married, widowed or divorced woman, give also maiden name.)


8 Siren Street


St


(If nonresident, give city or town and State)


Length of stay: In place of death .......... years .......... months .......... days. In place of residence.


20


ears ..


...... months .......... days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


August ..... 201963


(Month)


(Day)


(Year)


4.


June


19.


I HEREBY CERTIFY


46


; That I attended deceased from


1963


to ...


QUE 20


death is said to


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


ACUTE CORONARY OCC.


INTERVAL BETWEEN ONSET AND DEATH 275


(a)


Due To ARTERIOSCLEROTIC AND


(b)


Idue To


HYPERTHYROID ITEART


(c)


DU EAURICULAR FIBAHAD


OTHER


SIGNIFICANT


CONDITIONS


NONE


Was autopsy performed?


No


What test confirmed diagnosis ?


CLINICAL


5 Was disease or injury in any way related to occupation of deceased! If so, specify


(Signature)


myron b. King


......


M. D.


MYRON N. K ING (M.D)


2:2 p. (Print or Type Name)


(Address) MINDFULD MAG „Date. QUE 2163


6


Winthrop Cemetery


Winthrop


....


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


August 23,


19.63


7 NAME OF


FUNERAL DIRECTOR


Arthur J. O'Maley


Winthrop Mass.


ADDRESS


Received and filed


AUG 2.2 1963


19


8 SEX


Female


9 COLOR


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


DIVORMarried


UNKNOWN


11 If married, widowed, or divorced


HUSBAND of


Charles .... Beattie


(or) WIFE of.


(Husband's name in full)


12


AGE ... 59 Years


Months ..


.Days


If under 24 hours


Hours ........ Minutes


4uns


Occupati


13 Usual


Switchboard ... Operator


(Kind of work done during most working life)


14 Industry


or Business :


Telephone


15 Social Security No ..


16 BIRTHPLACE (City) (State or country) Somerville


Mass


PARENTS


17 NAME OF


FATHER


Ben jamin Robbins


18 BIRTHPLACE OF


FATHER (City)


Boston


(State or country)


Mass


19 MAIDEN NAME


OF MOTHER


Elizabeth Runey


20 BIRTHPLACE OF


MOTHER (City)


Somerville


Mass


(State or country)


2I Informant


Charles Beattie


(Address)


8 Siren St., Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: j'aiph & Serianni (S) (Signature of Agent of Board of Health or other) Health Officer august 22, 1963


(Registrar) | (Official Designation)


(Date of Issue of Permit)


TVP


A TRUE COPY ATTEST:


2382


urial permit of Health gent. IONS


TIFICATE


TYPE CAUSES TH nter one each and (c)


not mean f dying, failure, It means compli- caused


if any. rise to e (a), under- e last.


s contrib- but not terminal ion given


No ...


8.Siren Street


L


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(a)


Residence. No.


(Usual place of abode)


PERSONAL AND STATISTICAL PARTICULARS


(Give maiden name of wife in full)


I last saw helalive on


QUE-16


063


have occurred on the date stated above, at 600Am.


.....


1 YR


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE.


DATE OF DISCHARGE RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


RULES OF PRACTICE


12


.1


5


6


THROP


AUG 2 21963 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.


R-301


rial permit Health ent. ONS


IFICATE


TYPE AUSES CH ter one each nd (c) ot mean dying, failure, t means compli- caused


f any, rise to (a), under- last.


contrib- but not terminal n given


PLACE OF DEATH


Suffolk


BOSTON 8-26-63


The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


Registered No.


160


S(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME ....


Angelina (Diorio) Ceruolo


(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 .... 49Bayswater St.


(Usual place of abode)


St.


East .Boston, Mass


(If nonresident, give city or town and State)


Length of stay: In place of death ......... years ......... months 5 days. In place of residence 5 years.


.months.


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


F


9 COLOR


White


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN


(write the word)


Divorced


11 If married, widowed, or divorced HUSBAND of


(or) WIFE of


Nicholas Ceruolo


(Husband's name in full)


12


AGES6


Years.


Months.


.Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :


(Kind of work done during most working life)


14 Industry


or Business:


7. W. Woolworth Co.


15 Social Security No ....


unknown


025-12-1914


16 BIRTHPLACE (City)


(State or country)


Chelsea M 11.


17 NAME OF


FATHER


Domenic DiOrio


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Susie Tontodonato


20 BIRTHPLACE OF MOTHER (City) (State or country)


Italy


21 Informant


Susie DiOrio (mother)


(Address)


49 Bayswater St., East Doston, Mass.


I HEREBY CERTIFY that a satisfactory standard certificate of death was fled with me BEFORE the burial or transit permit was issued:


(Signature of Agent of Board of Health or other)


Health Officer


august 2.2.1963


(Official Designation)


(Date of Issue of Permit)


IT X


A TRUE COPY ATTEST:


20


1963


(Month)


(Day)


(Year)


4 IHEREBY CERTIFY,


7/26


19 63


to ...


8 - 20.


19


That I attended deceased from 63


I last saw h&kalive on


8-20-


1963


death is said to


have occurred on the date stated above, at


... m.


9A


INTERVAL BETWEEN ONSET AND DEATH


(a) CEREBRAL HEMORRHAGE


1/2 tur years


Due To


(b)


HYPERTENSION


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Was autopsy performed?


NO


What test confirmed diagnosis ?


CLINICAL


5 Was disease or injury in any way related to occupation of deceased? NO If so, specify


(Signature)


M. D. Pasquale Costanza MB


238


Maverick


(Print or Type Name)


8/21


63


(Address)


Last Poston Date.


19


Holy Cross Cemetery


Malden


6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


August 24


19 63


7 NAME OF


FUNERAL DIRECTOR


Vincent Rasino


ADDRESS


9 Chelsea St., East Doston


Received and filed


AUG 2 2 1963


19.


(Registrar )|


2382


I


(County)


Winthrop


(City or Town)


NO ... WINTHROP COMMUNITY HOSPITAL


(City or Town making this return)


PARENTS


Pasquale Cortana a


Salesgirl


(Give maiden name of wife in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


3 DATE OF


DEATH


August


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 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 Operson 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.




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