USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 1
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مهيو
中★むすサイすすます
ـحي
مهرم
J. L. FAIRBANKS DIV. Thomas Groom & Co. Stationers 105 State St., Boston
To duplicate this book order No. 741-10 O.U.7
R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No.
57 Ocean View Street
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY 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. [ give its NAME instead of street and number)
2 FULL NAME
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
57 Ocean View Street
St.
(If nonresident, give clty or town and State)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months
days.
In this community 37 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACEI
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divorced HUSBAND of
Maud Ricard
(or) WIFE of
( Husband's name in full)
6 Age of husband or wife if elive 63 Yrs. years
7 IF STILLBORN, enter that fect here.
8
AGE
67
Years
10
Months
23 Days
If less then 1 day
Hours
Minutes
Usual
Building Inspector
9 Occupetion :
Industry
Town Of Winthrop
10 or Business :
11 Social Security No.
020-12- 0130
Benezett
12 BIRTHPLACE (City)
(State or country)
Penn.
13 NAME OF
FATHER
John Overturf
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Penn.
15 MAIDEN NAME
OF MOTHER
Elizabeth Johnson
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Penn.
17 Maud Overturf
Relation If any
Informant
( Address }
57 Ocean view st. Winthrop
i HEREBY CERTIFY, that a satisfactory standard certificate of deeth wes filed with me BEFORE the burial or transit permit was Issued :
(Signature of Agent of Board of Health or other) Health spielt 1/7/46
( Date of Issue of Permity
18 DATE OF
DEATH
( Month)
(Day)
(Year)
19
HEREBY CERTIFY,
at I attended deosased from
Jan 1
19 40
...
Ło
Dan 3
19.4.15
test saw h Za alive on ...
2 27, 19 20, death Is said to
have occurred on the date stated above, at
8 4
m.
Immediate ceuse of death.
IMPORTANT
masaccenditi
Due to.
Elene Brevelite
Due to
Chirona Cuttento
5 yrs.
Other conditions.
( Include pregnancy within 3 months of death)
Mejor findings :
Of operations
Date of.
Of eutopsy
What test confirmed dlegnosla?
20 Was disease ofinjury in any wey related to oooupation of deceased ? 100
If so, spsoify.
Sty Lers 7 Salerno
(Signed)
M. D.
(Address ) 75 Pleasant St
Date. Bom5 1946
Winthrop
Place of Burial, Cremation or Removal,
DATE OF BURIAL DOCJanuary
7
19
46
22 NAME OF
B Forward S Arnold
FUNERAL DIRECTOR ADDRESS
Received and fled ....... JANA 1343 19
( Registrar)
100m(i).1-44-13634
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that of.sot.
1
Silas Arthur Overturf
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
3
1946
Male
White
MEDICAL CERTIFICATE OF DEATH
Duration
6 mes. ..... 1 yr
IMPORTANT
Physician
Underline the cause to which death should be charged sta- tistically.
21
Winthrop
(City or Town)
( Official Designation)
(Usual place of abode)
(Cive maiden name of wife in full)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom be has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and helief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Cbap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required hy the preceding section or hy section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and helief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert iu the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate hoth the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the Cbina relief expedition and the Philippine insurrection, which shall, for said purposes, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person sball bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the hody is buried. No such permit sball he issued until there shall have been delivered to such hoard, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a pbysi- cian who is a member of the board of health, or employed by it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human hody, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained bereunder. If the death certificate contains a recital, as required
by section ten or chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can he obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead hodies of only such persons as are supposed to bave died hy violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the hody is to he huried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . .. Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to sucb deaths only as those of persons who, though disabled by recognized disease unrelated to any forum of injury, bave died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and hy 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 occupation, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, 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 occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he 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, how- ever, designate the occupation hy the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
If deceased was a U. S. War Veteran, Q. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
1
PLACE OF DEATH
(County)
(City or 15ª Villa are No.
.... /
SŁ
§ (If death occurred in a hospital or institution, { give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR).
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
months days.
In this community
87 yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
VSEX Female
4 COLOR OR RACE
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Sa If married, widowed, or divorced
HUSBAND of
7,00000
(or) WIFE of
David
( Give maiden nepro
et wife in full)
( Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 AGE 87 Years
Months
..... Days
If lesa than 1 dey
Hours
Minutos
Usual'
9 Ocouoation :
Jamie
Industry 10 or Business :
11 Social Security No.
Hunchop
12 BIRTHPLACE (City)
(Simte or country)
Thank
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (Clty)
Sinisquam
(State or country)
Maks
15 MAIDEN NAME
OF MOTHER
Mary Border.
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Chatham
17 Jedna Griffin (Practic.
Ralation, INany
Informant
( Address)
5Vilta Maul
I HEREBY CERTIFY that a satisfactory standard certiftoate of death was filed with me BEFORE the burial or transit parmit was Issued ? Tomo Children 2 ADDRESS
HO. OHC
(Signature of Agent of Board of Health or other) Jan. 3746.
(Omcial Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
January
3
1446
(Month)
(Đay)
(Year)
19 | HEREBY CERTIFY.
200 15
1945, to
Hay 3
19
1 last saw
h.
Or alive on
Jan
3
. 19 46 death is said to
have occurred on the dato stated above, at.
7.15P
n.
immediato oquse of death.
Cerebral Heimmarchage
IMPORTANT
......
Due to
Esteno Salesorias
Журавльны
Due to
& Senility
Other conditions.
( Include pregnancy within 8 months of death)
Major findings :
Of operations
Date of
Of autopsy
What test confirmed diagnosis?
Clinical Signs
IMPORTANT
Physician Underline the cause to which death should be charged sta. tistically.
20 Was disease or injury in any way related to occupation of deceased $20 If so, spsoify.
M. D.
('Signed)
(Address)
8 20 in/Trop Date 445 1946
Place of Burial, Cremationfor Removal.
(City or Towny
..........
21
BURIAL fazy 5
19.455
22 NAME OF
FUNERAL DIRECTOR ...
Received and fied JAN/ 1315
(Registrar)
2
Registered No.
2 FULL NAME
( If deceased is @ jharried, widowed of divorced (woman, give alde maiden name.)
254 Theo
mogene
Imogene & While (Griffin){
St.
(If nonresident, give city or town and State)
That I attended deceased from
46
Duration
PARENTS
100m.(g)-1-45-15510
1 R-301 A
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom be has attended during his last illness, at the request of an undertaker or otber authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death . .. Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of this sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen bundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, bis certificate cannot be obtained early enough for the purpose, or is insufficient, a pbysi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a buman body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained bereunder. If the death certificate contains a recital, as required
by section ten or chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifylng the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.
No undertaker or other person sball bury a buman body or the asbes thereof which have been brought into the commonwealth until be has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. . . . Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
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 unrelated 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 phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably 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 occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, 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 occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman wbose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
M R-301 A
1
PLACE OF DEATH No.
Suffolk (County)
arlington notified 2/7/4
Winthrop (City or Town) 125 Cliff Ave.
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
3
st. ¿ (If death occurred in a hospital or institution, give its NAME instead of street and nun ber)
2 FULL NAME
Margaret Mac Donald Haraden
(If deceased is a married. widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
( Was deceased a
3 GS, War Veteran,
if so specify WAR)
(a) Residence. No.
194
Park Ave
Arlington ..
St.
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
8
months
days.
In this community 3
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(Usual place of abode)
3 SEX
4
COLDR OR RACE
Female
White
5a If married, widowed or divorced
HUSBAND of ..
(or) WIFE of
7 IF STILLBORN, enter that fact here.
8
AGE
76 Years
Months
Days
Usual
9 Occupation:
Housewife
Industry
10 or Business:
Own Home
11 Social Security No.
13 NAME DF
FATHER Angus MacDonald
PARENTS
16 BIRTHPLACE DF
MDTHER (City).
(State or Country)
P.E.I.
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
See instructions and extracts from the laws on back of certificate.
DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important.
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF
14 BIRTHPLACE DF
FATHER (City)
(State or Country)
P.E.I.
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
(Give maiden name of wife in full)
Marshall A.
(Husband's name in full)
Haraden
6 Age of husband or wife if alive years
If less than 1 day
Hours
Minutes
12 BIRTHPLACE (City).
(State or Country)
Prince Edward Island
15 MAIDEN NAME
DF MDTHEMary
Mc Intyre
17 Marshall Haraden ( Born, if any
Informant
(Address)
7
Elmwood CourtWinthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
William
· Childress
(Signature of Agent of Board of Health or other)
agent
Jan 6/46
(Official Designation)
(Date of Issue of Permit)
18 DATE OF
DEATH
(Month)
(Day)
1946 (Ycar)
19 SMA, . 1945 , to
I HEREBY CERTIFY,
That I attended deceased from
Azny
, 19
46
I last saw h/
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