Town of Winthrop : Record of Deaths 1963, Part 53

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1963 > Part 53


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


Winthrop Community Hospital


[(If death occurred in a hospital or institution,


St. ¿ give its NAME instead of street and number)


204 Shirley Street


St


Winthrop, Mass.


(If nonresident, give city or town and State)


(Give maiden name of wife in full)


INTERVAL BETWEEN ONSET AND DEATH 10min 12.77


Due To


(b)


tended deceased, from 63


lee3


1963 death is said to


No.


-


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT


SERVICE NUMBER


RULES OF PRACTICE


RECEIVED


TOWI


OFFICE O


71 12.


In.


MIN


CLERK


W


MAS


R


1964 PM


JAN 3 ·


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 bad 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.


I


PLACE OF DEATH


SUFFOLK


(County)


BOSTON


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


STANDARD CERTIFICATE OF DEATH


270


(City or Town making this return)


11643


Registered No. [(If death occurred in a hospital or institution, .St. ( give its NAME instead of street and number) PHYSICIAN - IMPORTANT


2 FULL NAME


Guy Frizzi


(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 .... 10 .... Locust .... Street.


(Usual place of abode)


St .... Winthrop, ... Mass ..


(City of 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


male


9 COLOR


white


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN


(write the word)


widowed


Il If married, widowed, or divorced


HUSBAND of


(or) WIFE of.


Jennie Bonfiglio


(Give maiden name of wife in full)


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


INTERVAL BETWEEN ONSET ANO DEATH


4 hour


S AGE.


... ..... Years.


Months.


Days


If under 24 hours


Hours ........ Minutes


-


(b)


Arteriosclerotic ... heart


disease


Due To


(c)


OTHERChronic bronchitis and


SIGNIFICANT emphysema


CONDITIONS


Diabetes mellitus


Was autopsy performed ? .... no


What test confirmed diagnosis ? clinical


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


If so, specify .


@@.@low


M. D.


(Signature)


.Charlas.L.Clay, M. D.


(Print or Type Name)


(Address) Aar.t. Dir .. Mens, Gon'l, Hosp. Date.Nov .19 9 63


6


St. Michael Cemetery Boston


Place of Burial or Cremation


Nov. 22,


1963


.........


(City or Town)


DATE OF BURIAL


7 NAME OF


FUNERAL DIRECTOR


Vincent R. Rapino


ADDRESS 9 Chelsea St. EastBoston Mass


NOV-2-97-1963 Received and filed Williamf. Kane.


PARENTS


17 NAME OF


FATHER


Angelo Frizzi


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Victoria Bonasera


20 BIRTHPLACE OF


MOTHER (City).


(State or country)


Italy


21 Informant


Sarno Frizzi (som)


10 Locust St. Winthrop, Mass


......


(Addres


I HEREBY CERTIFY that a satisfactory standard certificate of death way filed with me BEFORE the byristor transit permit was issued:


Signature of Agent of Board of Health or orbey)


19362 11/21/63


..... (Registrar)|| (Official Designation)


(Date of Issue of Permit)


1


M R-301


burial permit of Health gent. TIONS R RTIFICATE


R TYPE CAUSES ATH enter an one or each ) and (c)


of dying, ort failure, :. It means or compli- ich caused


, if any, e rise to use (.).


As contrib- th but not he terminal ition given


20.1 81 170


16 1964 recten se only Ink.


(City or Town)


-


NOMASSACHUSETTS GENERAL HOSPITAL


Gaetano


.........


3 DATE OF


DEATH


November


19


1963


(Month)


(Day)


(Year)


4 THERENY CERTIFY , That Heattended deceased from


November .17 , 19 63


to .. November .... 19.


19 .. 63


Wel last saw himlive on .. November ..... 19 ........... 1963, death is said to


have occurred on the date stated above, at .. 2:15 ... a .. m.


(a) Acute myocardial infarction


12


74


13 Usual


Occupation :


Retired


(Kind of work done during most of iworking life)


14 Industry


or Business:


*****


15 Social Security No.


025-09-0148


20 years 16 BIRTHPLACE (City)


20 year


(Husband's name in full)


Due To


6 years


(State or country ) Italy


-


933404


wse last.


TRUE COPY ATTEST:


Williaml. Kane. City Registrar


MF TOW;


1


CLERK


6 5


!THROP MA


JAN 1 61964 AM


R-301 1


urial permit of Health gent. ONS


IFICATE


TYPE AUSES TH ter one each nd (c)


ol mean dying, failure, It means compli- caused


1 amy, rise to (a), under- last .


contrib- but not terminal os given


67. 0)


16 1964 rector


only Ink.


2382


PLACE OF DEATH


MITT - AND - TOWN SUFFOLK


(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


271


(City or Town making this return)


11892


Registered No.


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


PHYSICIAN - IMPORTANT


(Was deceased a


no


U. S. War Veteran,


if so specify WAR)


85 Quincy Avenue, Winthrop Massachusetts


(a)


Residence. No ...


(Usual place of abode)


(If nonresident, give city or town and State)


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


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


Malo


9 COLOR


White


10 SINGLE


MARRIED


(write the word)


WIDOWED Married


DIVORCED


UNKNOWN


11 If married, widowed, or divorced.


HUSBAND of


Flávia Pino


(or) WIFE of.


(Husband's name In full)


12


AGE


Years.


Months ...


.. Days


If under 24 hours


Hours ........ Minutes


contractor


13 Usual


Occupation :


(Kind of work done during most working life)


14 Industry


PROof's


or Business :


016 26 0423


15 Social Security No.


16 BIRTHPLACE (City)


(State or country)


Italy


17 NAME OF


FATHER


Dominico


MANdiLe


18 BIRTHPLACE OF


FATHER (City).


Italy


(State or country)


9 MAIDEN NA


OF MOTHER


Margarita Mandilo


20 BIRTHPLACE OF


MOTHER (City) ..


(State or country)


Italy ...


Mrs. Flavia Mandile


21 Informant


(Addresi)


85 Quincy Avo. Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: R.K. Jamon


(Signature of Agent of Board of Health of other)


19455


11/29/63


(Date of Issue of Permit)


(Registrar)|| (Official Designation)


Williamg.


YEARS


Was autopsy performed ?


What test confirmed diagnosis ?


Autopsy


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


(Signature)


-cella


M. D.


-Charles. L. Clay, M.D.


(Print or Type Name)


(Address) Ass's. Dis., Mass .. Con.L. Hosp .... Date .: Winthrop.


Winthrop Cemetery


6


Place of Burial or Cremation


Nov 30.


(City or Town) 63. DATE OF BURIAL


19 ....


7 NAME OF


FUNERAL DIRECTOR Maurice W. Kirby.


210 Winthrop St. Winthrop.


ADDRESS


Received and filed


DEC 2 1963 /auce


INTERVAL BETWEEN ONSET AND DEATH WBoks


Due To (b)


Due To (c)


OTHER


SIGNIFICANT MYOCARDIAL INFARCTION


CONDITIONS


OLD HEALED


That Iwstended deceased from


19. November 26 6 last saw hh.Mlive November 26 . 16 3., death is said to have occurred on the date stated above, at 7.50pm


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


ACUTE PANCREATITIS


(a)


3 DATE OF


November 26,


1963


(Month)


(Day)


(Year)


NI HEREBY vomber f & 6.3


DEATH


No


Massachusetts General Hospital BAKER MEMORIAL


Antonio Mandilo,


2 FULL NAME ..


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


.....


11-27-63


PARENTS


(Give maiden name of wife in full)


A TRUE COPY ATTEST'!


City Registrar


REDE YED


OF TOWN


11. 12.


-19 1


LERK


6 5


JAN 1 61964 AM


OUT - OF - TOWN


SUFFOLK


....


(County)


BOSTON


(City or Town)


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


272


(City or Town making this return)


Registered No.


12103


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


PHYSICIAN - IMPORTANT


2 FULL NAME


Cabina Stocco


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


20


(a) Residence. No ...........


££Harvard 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. 9


... years .......... 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)


married


11 If married, widowed, or divorced HUSBAND of


(or) WIFE of.


(Give maiden name of wife in full)


Frank Stocco


(Husband's name in full)


12


50


Years.


Months.


.. Days


If under 24 hours


Hours ........ Minutes


13 Usual


Occupation :.


Stitcher


(Kind of work done during most working life)


14 Industry


or Business :


Crown Dress M&g. Co.


15 Social Security No. 011-05-5020


16 BIRTHPLACE (City)


(State or country)


Italy


17 NAME OF


FATHER


Frank Aloi


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Maria Ligotti


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


Frank Stocco (husband)


21 Informant


(Address)


20 Haward St., Winthrop, Mass.


I HEREBY CENTIEY that a tyisfactory standard certificate of death was filed withme BEFORE the Burial or transit permis


.........


Simsturdy Agent of Bord


1952


(Registrar)|| (Official Designation)


(Date of Iagde of Bermit)


1 X


A TRUE COPY ATTEST:


1963


(Day)


(Year)


4 I HEREBY CERTIFY , That Iwettended deceased from


Dec. 2,


.63


Dec. 2,


63


OF last saw


bralive on Dec .... 2,


163., death is said to


have occurred on the date stated above, at } ...... 2} ............. m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) -Subarachnoid Hemorrhage


Due To (b)


Due To (c)


OTHER


SIGNIFICANTron ... Deficiency Anemia


CONDITIONS


3 years


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


@c.Clar


(Signature)


M. D.


. Charles L. Clay, M.D.


(Print or Type Name) (Address) Ass's .. Dis., Mass. Gen'] .. Hosp ..... Date .. Dec ...... 2.,.19 ... 63.


6


St. Michael Cemetery Boston


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


December 5,


19 63


7 NAME OF


FUNERAL DIRECTOR


Anthony P. Kapino


ADDRESS


9 Chelsea St, East Boston, Mass


Refined Diane Lane.


I .... DEC. ..... 5 1963


X I


ORM R-301


for burial permit rd of Health s Agent. RUCTIONS FOR CERTIFICATE


OR TYPE OR CAUSES DEATH ot enter than one for each (b) and (e)


Does not mean e of dying, heart failure. etc. It means e, or compli- which caused


-


ons, if any, gave rise to cause (a). the under- cause last.


itions contrib- death but not the terminal ondition given


330 70


V 24 1964 Directen uso caly CK Ink.


ogera


was issued:


.


hay /4163


2-932382


PLACE OF DEATH I


No. MASSACHUSETTS.GENERAL .. HOSPITAL Catena


(Was deceased a


U. S. War Veteran,


(if so specify WAR)


3 DATE OF


DEATH


Dec ...... 2,


(Month)


to ....


INTERVAL BETWEEN ONSET AND DEATH 2 hour


PARENTS


A TRUE COPY ATTEST:


Williamf. Kance. City Registrar


TOM


6


5


INT


JAN 2 41964 AM


X


PLACE OF DEATH


Suffolk


(County)


Revere


(City or Town)


The Commonwealth of Massachusetts KEVIN H. WHITE SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF GVILT CERTIFICATE OF DEATH


Revere


273


(City or Town making this return)


Registered No.


f(If death occurred in a hospital or institution,


St. ( give its NAME instead of street and number)


2 FULL NAME.


George N. Dracos


(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


40 Sea View Ave.


(Usual place of abode)


St


(If nonresident, give city or town and State)


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


2.


.years .......... months .......... days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


December


5,


1963


DEATH


(Month)


(Day)


(Year)


4 LHEREBY CE)


July 27


19


to.


66 TIFY,


That I attended deceased from


Dec.


19


63


I last saw himmive on


Dec.


4. 6 death is said to


. 19.


have occurred on the date stated above, at


12:35 Pm ..


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Arteriosclerotic Heart


Disease


(a)


Due To Arteriosclerosis


(b)


generalized


5yrs.


Due To (c)


OTHER


Idiopathic


SIGNIFICANT


CONDITIONS


Parkinsonism


5yrs.


16 BIRTHPLACE (City)


(State or country)


Greece


17 NAME OF


FATHER


Nicholas Dracos


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Greece


19 MAIDEN NAME


OF MOTHER


Margaret Spelios


20 BIRTHPLACE OF


MOTHER (City).


(State or country)


Greece


Mary Dracos


21 Informant


( Address)


40 Sea View Ave., Winthrop


A TRUE COPY


ATTEST:


(Registrar of City or Town where death occurred)


DATE FILED


December


9,


19.63 '


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.)


6


Place of Burial or Cremation


(City or Town)


63


19


DATE OF BURIAL


December


7,


7 NAME OF


Paul K. Babalas


FUNERAL DIRECTOR


ADDRESS


336 Broadway, Cambridge


Received and filed


JAN 15 1964


19


(Registrar of City or Town where deceased resided)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Male


9 COLOR


White


10 SINGLE MARRIED WIDOWED DIVORCED UNKNOWN


(write the word)


Married


11 If married, widowed,


Mawy Rodes


HUSBAND of


(Give maiden name of wife in full)


INTERVAL


BETWEEN


ONSET AND


(or) WIFE of


DEATH


12


2yrs.


Years.


Months ............ Day3


If under 24 hours


Hours ..


Minutes


13 Usual


Occupation :


Grocery Store


(Kind of work done during most working life)


14 Industry


or Business :


Retired


15 Social Security No.


013-28-7332


Was autopsy performed?


No


Clinical findings


NO


......


What test confirmed diagnosis ?


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


(Signed)


John F. Collins


M. D.


27 Bennington St. 12/6


63


(Address)


Revere


Date.


19


Winthrop Cemetery Winthrop


PARENTS


50M · 10-61-931673


M R-302


1


400 Revere Beach No


(a) Residence. No ..


Winthrop


(Husband's name in full)


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER


IF TON


1


6


TI


JAN 1 5 1964 AM


PLACE OF DEATH


Suffolk 1 - TOMAS


(County)


Boston


(City or Town)


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


274


(City or Town making this return)


1.2226


Registered No.


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


2 FULL NAME


Irene T. Norris


(If deceased is a inarried, widowed or divorced woman, give also maiden nagle.)


95 Loring Road, Winthrop, Mass.


(Usual place of abode)


St


(If nonresident, give city or town and State)


Length of stay: In place of death .......... years ....


9 months ........ days. In place of residence 22 years.


.......


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


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


December


6


1963


(Month)


(Day)


(Year)


4


19


6.3


I HEREBY CERTIFY,


That I attended deceased from


Fe.b. ....... 2.5.,. 19 .... 6.3.


.. , to.


December 6.


I last saw h.e.Mve on December ..... 6 ...... , 19 .... 6, Death is said to


have occurred on the date stated above, at


3:45am.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


Bilateral Lobar Pneumonia


(a)


INTERVAL BETWEEN ONSET AND DEATH


probably tuberculous


Due To


Arteriosclerotic Heart


(b)


Due To


(c)


Disease with old antero- ... septal ..... myocardial/infarct and acute myocardial


OTHER


SIGNIFICANT


CONDITIONS


extension.


Was autopsy performed ?


....


Yes


What test confirmed diagnosis ?


......


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


If so, spesify


Print or Type Name) Dand S. Sherman M. D. PARENTS


(Addres 2 49 Rue Sie mattabaDate


Dec 6 19 63


6 ...


WIKITHR WA WINTHROP- .....


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


DEC


9


945


7 NAME OF


FUNERAL DIRECTOR


MAURICE W. KIRBY


ADDRESS


WINTHIRUP.


DEC 1-0 1963 tilham. Kay 311614


(Registrar)| (Official Designation)


A TRUE COPY ATTESTI


8 SEX


10 SINGLE


(write the word)


FEMALE


9 COLOR


WHITE


MARRIED


WIDOWED


DIVORCED


UNKNOWN'


NIDINED


11 If married, widowed, or divorced HUSBAND of


(or) WIFE of.


JOHN M. NORRIS


(Husband's name in full)


12


AGE 76 Years


Months ..


........


... Days


If under 24 hours


.Hours ........ Minutes


13 Usual


Occupation:


HOME MAKER


(Kind of work done during most working life)


· 14 Industry


or Business :


HUME


15 Social Security No.


NONE


16 BIRTHPLACE (City)


(State or country)


MASS.


17 NAME OF


FATHER


GILBERT MORRISON


18 BIRTHPLACE OF


FATHER (City)


(State or country)


SCOTLAND.


19 MAIDEN NAME


OF MOTHER


ANNE T LONG


20 BIRTHPLACE OF


MOTHER (City)


ST. JOHNS


(State or country)


N.B.


MAS CATHERINE CURRAN


21 Informant


(Address)


72 TREATON ST MELROSE MASS


I HEREBY CERTIFY that a satisfactory standard certificate of death fed with me BEFORE the buri Poyr transit permit waa Issued: Frank P-fraca


(Signature of Ageat { Board of Health or other) Dec, 8,1963 ..... (Date of Issue of Permit)


X 1


M R-301 -115


burial permit of Health Agent. TIONS


TIFICATE


TYPE CAUSES ATH enter in one r each and (c)


not mean of dying, ut failure, . It means or compli- ch camsed


, if any, e rise to se (.), e under. se last.


as contrib- th but not" se terminel ition given


20.1 81 20 274984


32382


No ....


Boston Sanatorium


(Was deceased a


U. S. War Veteran,


(if so specify WAR)


NO


(a) Residence. No ....


(Give maiden name of wife in full)


NUTH BROOKFIELD


(Signature)


SHERMAN


A TRUE COPY ATTEST:


Williamf icane. City Registrar


5


THEOP


JAN 2 41964 AM


ORM R-301


for burial permit ard of Health ta Agent. UCTIONS FOR CERTIFICATE


OR TYPE OR CAUSES DEATH ot enter than one for each (b) and (c)


oes not mean of dying, heart failure. etc. It means e, or compli- which caused


ons, if any, gave rise to cause (), the under. cause last.


itions contrib- death but not the terminal ondition given


33, 10


124 1964


62-934553


PLACE OF DEATH


Suffolk


(County)


-


Boston


(City or Town)


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


275


(City or Town making this return)


12422


Registered No.


[(If death occurred in a hospital or institution,


St. ( give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


2 FULL NAME


Pantonino


Carmelo


(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 deathyears months L


days. In place of residence .......... years .......... months .......... days.


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Male


9 COLOR


White


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN


(write the word)


Married


11 If married, widowed, or divorced HUSBAND of


Concetta Alongi


(Give maiden name of wife in full)


(or) WIFE of.


(Husband's name in full)


12


AGE


74


Years


5


Months


24


.Days


If under 24 hours


Hours ........ Minutes


13 Usual


Fireman, retired


Occupation


(Kind of work done during most of working life)


14 Industry


or Business


15 Social Security No ..


2 dayis BIRTHPLACE (City)


(State or country)


Italy


17 NAME OF


FATHER


Peter Carmelo


18 BIRTHPLACE OF


FATHER (City).


(State or country)


Italy


19 MAIDEN NAME


OF MOTHER


Francis Busacco


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Italy


21 Informant


V ...... A ..... Hospital .. Records, .... 150 .......


Huntington Ave., Boston, Mass.


I HEREBY CERTIFY that


satisfactory standard certificate of death was issued:


with me BEFORE the portal quesiger 2 .


(Signature+ Agent of Board ( FHalth other)


19653


/12/13/63


(Date of Issue of Permit)


A TRUE COPY ATTEST:


INTERVAL BETWEEN ONSET AND DEATH 2 days


Due To (b)


Due To (c) .....


OTHER SIGNIFICANT


Pulmonary congestion and CONDITIONSedema and bronchopneumonia


Was autopsy performed?


What test confirmed diagnosis ?


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


(Signature)


A&Weinstein


M. D.


...... (Print or Type Name) VAH/Boston, Mass.


Dec.12 ,63


19 ... ............


Winthrop Cem., Winthrop, Mass. 6


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


December 14


19.


63


7 NAME OF


FUNERAL DIRECTOR


Caggiano F. H.


ADDRESS


147 Winthrop St., Winthrop, Mass. was hled


Received and fled Williaml.


DEC 17 1953


Race strani (Oficial Designation)


........ ..........


St


Winthrop, Mass.


(City or town and State)


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


December


11


1963


DEATH


(Month)


(Day)


VA


(Year)


4 I HEREBY CERTIFY


Dec . 10


19


63


to


19 63


XXXXXXXXXXXXX death is said to have occurred on the date stated above, at .3.8.4.5P. m.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE Pontine hemorrhage


(a)


That


Deo a ]attended deceased from


if so specify WAR).


(Was deceased a


U. S. War Veteran,


WWI


47 Lincoln


CERTIFICATE OF DEATH


Ix Veterans Administration Hospital


X OUT - 01


...


(Address)


PARENTS


(Address)


in


-


A TRUE COPY ATION.


Wichauf Kane. City Registrar


1


[


6


JAN 2 41964 AM


RM R-301


or burial permit rd of Health Agent. UCTIONS FOR CERTIFICATE


OR TYPE R CAUSES EATH ot e.iter than one for each (b) and (c)


es not mean of dying. heart failure. etc. It means e, or compli- which caused


Rs, if any, ave rise to camse (a), the under- cause last.


tions contrib- death but not the terminal ndition given


$20.0


2 4 106 Direction use only CK ink.


2-932382


PLACE OF DEATH


(City or Town)


OUT - OF - TOWN The Commonwealth of Massachusetts KEVIN H. WHITE SUFFOLK SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS L' (County) BOSTON STANDARD CERTIFICATE OF DEATH


276


(City or Town making this return) 12419


Registered No.


[(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.


Shore .... Drive.


St


Winthrop, Mass


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay: In place of death .......... years ..


1


months .......... days. In place of residence2 ... y


.years


months.


... days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


9 COLOR


Temale White


10 SINGLE


MARRIED


WIDOWED


DIVORCED


UNKNOWN


(write the word)


Singles


4 I HEREBY CERTIFY , That Iwettended deceased from


November 11 19 63


19


63


to ...


December 12


W last saw h.elflive on .. December ..... 12 .......


19 .... 63death is said to


have occurred on the date stated above, at


2:08 pm.


DEATH WAS CAUSED BY: IMMEDIATE CAUSE


(a) Pulmonary Embolus


Due To


(b)


Atrial fibrillation


Due To (c)


OTHER


Coronary Heart Disease


SIGNIFICANT


CONDITIONS


unknow


Was autopsy perforined ?


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. D ....


(Print or Type Name) (Address) Aas's. Die., Mass .. Gen'L Hasp ...... Date ... Dec ...... 1219 .... 63


6 Wintherch Cemetery Wentworth .........


Place of Burial or Cremation


Dec


14


19.


63


.........


(City or Town)


DATE OF BURIAL


7 NAME OF FUNERA Ernest Plaggano 147 Winthrop ST Werkthron 1983 ADDRESS


Readyfor celiano Kauce


DEC 17-1963


8 SEX.


63


(Month)


(Day)


(Year)


11 If married, widowed, or divorced




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.