The Death and Burial of Wiktoria (Kruczyńska) Izbicki – 1948

Wiktoria (Kruczyńska) Izbicki, daughter of Kazimierz Kruczyński and Franciszka (or Elżbieta) Maslowska, widow of Bolesław Izbicki, died on 24 August 1948 in Worcester, Worcester County, Massachusetts, USA and was buried on 27 August 1948 in Notre Dame Cemetery, Worcester, Worcester County, Massachusetts, USA.

The Death and Burial Record of Wiktoria (Kruczyńska) Izbicki – 1948

SOURCE:  Worcester, Massachusetts, Death Records 1948, vol. 103: 407, Victoria (Kruczynski) Izbicki, Massachusetts Registry of Vital Records and Statistics, Dorchester.

Click on the link for a PDF copy of the death and burial record of Wiktoria (Kruczyńska) Izbicki .  The record states:

The Commonwealth of Massachusetts
OFFICE OF THE SECRETARY
DIVISION OF VITAL STATISTICS
STANDARD
CERTIFICATE OF DEATH
WORCESTER (City or town making return)  107
Registered No. 2005

1  PLACE OF DEATH  WORCESTER (County) WORCESTER (City or Town) F
No. 29 Belleview St., Â Â Â Â  Ward
{(If death occurred in a hospital or institution, give its NAME instead of street and number)

2  FULL NAME Victoria (Kruczynski) Izbicki (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 WAR)
(a) Residence .  (Usual place of abode) No. 29 Belleview St., Â Â Â Â  Ward, (If nonresident, give city or town and state)
Length of stay:  (Before death) (Specify whether) In hospital or institution     years    months     days
In this community  40 years     months     days

PERSONAL AND STATISTICAL PARTICULARS
3   SEX  female
4   COLOR OR RACE  white
5   SINGLE MARRIED WIDOWED or DIVORCED (write the word)  widowed
5a  If married, widowed, or divorced HUSBAND of      (Give maiden name of wife in full) (or) WIFE of Boleslaus Izbicki (Husband’s name in full)
6  Age of husband or wife if alive     years
7   IF STILLBORN, enter that fact here.
8   AGE  66 Years – Months – Days
If less than 1 day     Hours     Minutes
9  Usual Occupation:  at home
10  Industry or Business:
11  Social Security No .  none
12  BIRTHPLACE (City)    (State or country)  Poland  20-7
PARENTS
13  NAME OF FATHER  Kazimierz Kruczynski
14  BIRTHPLACE OF FATHER (City)    (State or country)  Poland  20-7
15  MAIDEN NAME OF MOTHER  Franciszka Maslowska
16  BIRTHPLACE OF MOTHER (City)    (State or country)  Poland  20-7
17  Informant  Walter Izbicki  (Relation, if any  son)
(Address)  Worcester

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
George D Melican
(Signature of Agent of Board of Health or other)
Dep Comm (Official Designation)
Aug 26, 1948 (Date of Issue of Permit)

MEDICAL CERTIFICATE OF DEATH
18  DATE OF DEATH  Aug 24, 1948 (Month) (Day) (Year)
19  I HEREBY CERTIFY that I attended deceased from
Aug 16, 1948 to Aug 24, 1948, death is said to
have occurred on the date stated above, at 4:30aM.
Immediate cause of death
Chronic myocarditis
93d
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy  –
What test confirmed diagnosis?  –
Duration Important  years
Important  Physician – Underline the cause to which death should be charged statistically.
20  Was disease or injury in any way related to occupation of deceased?  no
If so, specify
(Signed) Waldo Hagberg M.D.
(Address)  Worcester  Date  8-25 1948

21  Place of Burial, Cremation or Removal .  Notre Dame, Worcester (City or town)
DATE OF BURIAL  Aug. 27, 1948     19
23  NAME OF UNDERTAKER  L Karolkewicz
ADDRESS  Worcester

Received and filed Aug 27, 1948     19
[signed] Malcolm C Midgley (Registrar)
A TRUE COPY, ATTEST:

Copyright © 2011 by Stephen J. Danko