USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1956 > Part 1
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காது சாநினை
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مواعيد
中中山
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ヤOtIC中ャラ
卡中自小中专学学
141年年
中华华中
THOMAS GROOM & CO.INC. STATIONERS. AND ACCOUNT BOOK MANUFACTURERS 105 State Street. BOSTON.
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302
1
PLACE OF DEATH
SUFFOLK (County)) N
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or Town making this return)
150
A
Veterans Administration Hos ital. No.
§(If death occurred in a hospital or institution, { give its NAME instead of street and number)
RALPH I ANDERSON
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
989 Bennington St. E Boston
St
(If nonresident, give city or town and State)
Length of stay: In place of death ........... years.
months
23
11
days.
In place of residence.
ears
.months ............ days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
January 4, 1956
DEATH
(Month)
(Day) (Year)
4 [ HEREBY CERTIFY
That Aattended deceased from
Dec 22
19 55 Jan 4, 1956
19.
I tast sawy
11:50p
have occurred on the date stated ahove, at
m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Calcific aortic stenosis
Due To (b)
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
yes
What test confirmed diagnosis?
autopsy
no
5 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
Eric Sharton
(Address)
VAH, Boston 30
Date.
1/5/56
19
Winthrop Cem., Winthrop, Mass. 6
Place of Burial or Cremation
January 7, 1956
19
or Town)
DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby
ADDRESS E. Boston, Mass.
Received and filed.
FEB : 1956
19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
married
10a If married, widopedron diverged Hansen
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
58
AGE
Years
5 MG
Months.
18 Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Salesman
(Kind of work done during most of working life)
14 Industry
or Business :
Shoe
15 Social Security No ..
032-013-510
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
Frank I Anderson
PARENTS
18 BIRTHPLACE OF
Gloucester
FATHER (City)
(State or country)
Mass
19 MAIDEN NAME
OF MOTHER
Lillian V Witham
20 BIRTHPLACE OF
Gloucester
MOTHER (City)
(State or country)
Mass.
21
Hospital Records
(Address)
150 S. Huntington Ave., Bos
.
A TRUE COPY /
charles & Znackis
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
January 11, 1956
19
50M -11-55.916145
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.)
-
Registered No.
( Was deceased a
U. S. War Veteran,
(if so specify WAR)
WW I
(a) Residence. No. (Usual place of abode)
to
XXXX, death is said to
INTERVAL BETWEEN ONSET AND DEATH
yrs
M. D.
Bloucester
ECCOV
1
1
6
FEB-9 111
Jan 28, 1918 Dec 21, 1918 QM 2/c US Navy None
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
53 TaftSAve .
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(If deceased is a married, widowed or divorced woman, give also maiden name.)
6 Myrtle St.
St.
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
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDMarried
4 I HEREBY CERTIFY,
That I attended deceased from
november
to ...
January 4.
56
I last saw her alive on
December 20 1905, death is said to
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Charles G Huby
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
Years
65 2
Months
17
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation:
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
Own home
15 Social Security No.
010-18-0338
Hull
16 BIRTHPLACE (City)
(State or country)
England
17 NAME OF
FATHER
Henry Maddick
18 BIRTHPLACE OF FATHER (City) Hull (State or country) England
19 MAIDEN NAME
OF MOTHER
Ellen Florence Hill
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
Charston
21 Dorothy Fearing
Informant.
(Address)
55 Tart. Ave . Winthrop, Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter, S. Makers. (Signature of Agent of Board of Health or other)
1/6/56
(Official Designation)
(Date of Issue of Permit) /
1
RM R-301A 1
100M-10-53-910621
Received and filed JAN 6 1950 19
(Registrar)
1 yr.
Due To
(c)
OTHER SIGNIFICANT CONDITIONS
arteriosclerosis
igeneralized
1 yrs
Major findings:
Of operations.
Date of operation.
Was autopsy performed?
What test confirmed diagnosis?
5 Was disease of injury in any way related to occupation of deceased?
If so, specify.
no
(Address)
Westarting Date: 200 M. D. 1956
6 Winthrop
Place of Burial or Cremation
Winthrop (City or Town)
DATE OF BURIAL Jan. 6
19.5.6
7 NAME OF
FUNERAL DIRECTORA
ADDRESS
1.56.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial pormit with Board of Health or Its Agent.
2
Registered No.
2 FULL NAME ..
Edith M ( Maddick) Huby
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No.
(Usual place of abode)
3 DATE OF
DEATH
January
4
1956
(Year)
(Month)
(Day)
have occurred on the date stated above, at
4.35P.
m.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Carcinomatesis
Due To Carcinoma
ANTE CEDENT (b) CAUSES of lung
3 hrs
PARENTS
(write the word)
NSTRUCTIONS FOR CAL CERTIFICATE In giving SE OF DEATH o not enter ore than one use for each ), (b) and (c)
his does not mean de of dying, such t failure, asthenia. means the disease, aplications which death.
orbid conditions. giving rise to the cause (a) stating nderlying cause
ditions contrib- the death but not to the disease or on causing death.
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 he 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 belief the name of the deceased, his supposed age, the disease of which he died, defined as required 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 hy 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme -... diate 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 section and of sections forty-five, forty-six and forty-sever 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 hundredand ninety-eight and July fourth, nineteen hundred and two, and the Mexican. bordefilling rules of practice: service of nineteen hundred and sixteen and nineteen 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 bodyland 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 inter- ment, 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 be obtained early enough for the purpose, or is insufficient, a physician 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 required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human 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 hereunder. If the
-
death certificate contains a recital, as required by section ten of 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 registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary 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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. ... - General E ¡ Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received 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 follow-
6) (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
Into any form of injury.
1(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 wljen 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 occupation, 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 import- ant, 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. Children 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.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
.
ORGANIZATION AND OUTFIT
SERVICE NUMBER
X
PLACE OF DEATH
Suffolk (County)
winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN 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.
3
throw Comunity Hospital No. .......
.......
O' Brien
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 12 Undine Ave., (Usual place of abode)
...
St.
Revere
(If nonresident, give city or town and State)
Length of stay: In place of death years. months. days. In place of residence. .years ..
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
January
4
(Month)
(Day)
(Year)
8 SEX
Pomo.le
9 COLOR OR RACE
Thite
10 SINGLE
MARRIED
WIDOWED
or DIVORCED Single
4 I HEREBY CERTIFY.
That I attended deceased from
January 4 19. 56 to January 4 1956
I last saw her alive on
January 4 1056
death is said to
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEAL
Prematurity
TO DEATH (a)
8 Hours
12
AGE
.Years
Months.
Days
If under 24 hours
.. Hours
Minutes
13 Usual
Occupation:
none
(Kind of work done during most of working life)
14 Industry or Business :.
15 Social Security No. none
16 BIRTHPLACE (City) .... Winthrop. (State or country) Tass .
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation.
Was autopsy performed ?.
What test confirmed diagnosis?
5 Was disease of injury in any way related to occupation of deceased?
NO
If so, specify 0
(Signed)
M. D.
(Address). Rana mars Date 4 Jan 1956
6 Holy ross Lalden
Place of Burial or Cremation (City or Town)
DATE OF BURIAL ... January .... 9. 1956 19
7 NAME OF
FUNERAL DIRECTOR Arthur, Porcella
ADDRESS 876 Winthrop iva,, Devere" ass.
19
(Registrar)
PARENTS
17 NAME OF FATHER William O'brien
lovere 18 BIRTHPLACE OF FATHER (City) (State or country) ASS.
19 MAIDEN NAME OF MOTHER Barbara Carroll
20 BIRTHPLACE OF MOTHER (City) Boston (State or country) Mass.
21 Informant Ilion O'Brien
(Address) 12 Undine Ave., Revere,
asso
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter A aberg (Signature of Agent of Board of Health or other) Healthe Office
11 9 156
(Official Designation)
(Date of Issue of Permit)
×
RM R-301A 1
ISTRUCTIONS FOR CAL CERTIFICATE In giving SE OF DEATH o not enter ore than one use for each ), (b) and (c)
his does not mean de of dying, such t failure, asthenia. means the disease. aplications which death.
orbid conditions, giving rise to the cause (a) stating nderlying cause
ditions contrib- the death but not to the disease or on causing death.
100M-10-53-910621
J(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)
TTO
months days.
MEDICAL CERTIFICATE OF DEATH
have occurred on the date stated above, at 10.50 Pm
INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
ANTE Due To CEDENT (b) CAUSES
Due To (c)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(write the word)
1956
Registered No.
2 FULL NAME.
Baby Girl
Received and filed.
2-1.5
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 he 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 belief the name of the deceased, his supposed age, the disease of which he died, defined as required 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, specifying the war, and shall also certify in such certificate both the primary and the secondary of imme- diate 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 section 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 hundred and sixteen and nineteen 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 inter- ment, 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 be obtained early enough for the purpose, or is insufficient, a physician 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 required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human 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 hereunder. If the
death certificate contains a recital, as required by section ten of 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 registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary 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 persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received 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 follow- ing rules of practice:
(1) Attending physiciana will certify to such deaths only as those of persons to whom they have given bedside care during a last illness fron 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 withdyd recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiner's 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 occupation, the sudden deaths of os 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 import- ant, 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. Children 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.
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