USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 18
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 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70 | Part 71 | Part 72 | Part 73 | Part 74 | Part 75 | Part 76 | Part 77 | Part 78 | Part 79 | Part 80 | Part 81
SPACE FOR ADDITIONAL INFORMATION
DORM R-301 A
Sufflok
(City or Town) 14 Bates 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 ..
S (If death occurred in a hospital or institution. St. { give its NAME instead of street and number)
2 FULL NAME
Charlotte (Price) Brown
(If deceased is a married, widowed or divorced woman, give also maiden name.)
14 Bates Ave.
St
(If nonresident, give city or town and state)
Length of stay: In hospital or institution
(Specify whether)
years
months
days.
In this community 32
yTS.
mos. - days.
PERSONAL AND STATISTICAL PARTICULARS
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDHarried
(Give maiden name of wife in full)
Samuel A Brown
(Husband's name in full)
16
.years
If less than 1 day Hours .......... Minutes
12 BIRTHPLACE (City) .......
Fontiac ..
(State or country) Rhode Island
13 NAME OF
FATHER
James Price
14 BIRTHPLACE OF FATHER (City) ..... (State or country) England
Louise Knight
16 BIRTHPLACE OF
MOTHER (City)
Greenville
(State or country) Rhode Island
Relation, if any
Husband)
(Address) 14 Bates Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Win. S.Children (Signature of Agent of Board of Health or other)
Reality Officer 3/10/42
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
march
9
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
1
1941, to meuh 9
1942
I last saw her alive on mener 9
have occurred on the date stated above, at .......
Lg death is said to
12:30 1.
m.
Immediate cause of death
Duration
IMPORTANT
Due to Carmona of Stomach
6 monate
Due to.
Other conditions.
-
(Include pregnancy within 3 months of death)
IMPORTANT PHYSICIAN
Major findings:
Of operations.
Date of.
Of autopsy.
What test confirmed diagnosis ?.
20 Was disease or in ary in any way related to occupation of deceased? no
If so, specify
7 xilesas
(Signed) Louis 7 Saler
M. D.
17 (Address) 175 Please Si Date 3/14
19.0.1.2
21 ...
inthron
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL .....
12
22 NAME OF
Howard S Dumolds
FUNERAL DIRECTOR ....
ADDRESS.
Wintrop mais
Received and filed.
..... 19
(Registrar)
N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS 100m-2-440-D-729-8
1
No.
3 SEX
Female
(or) WIFE of.
AGE.
9 Occupation :..
Informant.
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
10 or Business :..
PLACE OF DEATH
(County)
Winthrop
(a) Residence. No.
(Usual place of abode)
4 COLOR OR RACE
White
Sa If married, widowed, or divorced
HUSBAND of
6 Age of husband or wife if alivo
7 IF STILLBORN. enter that fact here.
8
63
.. Years .........
Months ...........
17 Days
Usual
Housewife
11 Social Security No ..
15 MAIDEN NAME
OF MOTHER
17
Samuel Brown
is very important. See instructions and extracts from the laws on back of certificate.
CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION
Industry
Own Home
(If U. S.
War Veteran,
specify WAR)
1942
That I attended deceased from
Underline the cause to which death should be charged sta- tistically.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shali forthwith, after the death of a person whoin he has attended during his last iliness, 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 hy section one, where same was contracted, the duration of his last iliness, when last seen alive hy the physician or officer and the date of his death . . . Gen. Laws, Chap. 46. Sec. 9.
No undertaker or other person shail hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not heen huried, 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 hoard, from the cierk of the town where the person died; and no undertaker or other person shali exhume a human hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiv- ing tomh to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the cierk of the town where the hody is huried. 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 hy law to be returned and recorded, which shall he accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required hy 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 in- sufficient, a physician who is a member of the hoard of health, or em- ployed hy it or hy the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shali 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 he 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 re- moval of such hody has been sooner obtained hereunder. If the death certificate contains a recitai, as required hy 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 shali appear upon the permit. The board of heaith, or its agent, upon receipt of such statement and certificate, shail forthwith countersign It and transmit it to the cierk 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 necessary information which can be ohtalned 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).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until ile has received a permit so to do from the hoard 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 body is to he huried or the funeral is to he held, or from a person appointed to have the care of the cemetery or hurlal 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 ohservance 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 iliness 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 disahled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemla), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, hut 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 principai cause name the disease causing death. As related causes, name earlier morhid conditions, if any, related to the principal cause and any important complication of the principai cause.
Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfuiness of various pursuits can he known. Make some entry in this section for every person aged 10 years or over. If the occupation had heen given up or changed on account of the disease causing death, report the usual occupation prior to iliness. If the deceased had retired from huslness, report the usual occupation prior to retirement. 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 hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
ARM R-301 A
suffolk
(County)
inthrop
(City or Town)
....
The Commontoralth 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.
49
§ ( If death occurred In a hospital or Institution, St. (give its NAME instead of street and number)
2 FULL NAME
richard
Polson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
1 Sargent Terrace
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
( Before death)
(Specify whether)
years
months
days.
In this community 32 yrs. - mos. ~ days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE|
'hite
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the -word)
Single
18 DATE OF march
(Month)
DEATH
9
1942
(Day)
(Year)
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
years
7 IF STILLBORN. enter that faot here.
AGE
8
61
.Years
x
Months
17 Das
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Retired
10 or Business :
Industry
Insurance
11 Social Security No ....
Joincy
12 BIRTHPLACE (City)
(State or country)
Massachusetts
13 NAME OF
FATHER
Richard Folson
Major findings :
Of operations ...
prone
Physician
14 BIRTHPLACE OF
Boston
FATHER (City)
(State or country) Massachusetts
15 MAIDEN NAME
OF MOTHER
Susan K. Clark
16 BIRTHPLACE OF
Dorchester
MOTHER (City)
(State or country)
Massachusetts
(Address)
Monthroy
Date 2/9.
1942
21 Cedar Grove Cemetery
worchester (City or Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL
March 11
1942
19
22 NAME OF
FUNERAL DIRECTOR
Charles R. Bennison
ADDRESS
inthron
lass
Signature of Agent of Board of Health or other) Health Officer 3/10/42
(Official Designation)// (Date of Issue of Permit)
19
HEREBY CERTIFY,
That I attended deceased from
September
19
40
March-
42
to.
19.
I last saw him alive on
March 7, 1942, death Is said to
have occurred on the date stated above, at.
6 A.
m.
Duration IMPORTANT
Immediate cause of death
Cerebral hemorrhage
2
:
1
vasculare ret
Cardio vascular-renal disease
Due to.
Means
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
Uuderline the cause to which death should be charged sta- listically.
20 Was disease or injury in any way related to occupation of deceased? MD
If so, specify ...
Vy La Maman M. D.
(Signed)
17
Relation, if any
Informant ......
( Address)
I sargent errice
R ......
rs. Haud P. Mcclintock8
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued : m. S. Juldreng.
100m (d)-1-41-4667
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to Insert a recital to that effeot. 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 should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of information PARENTS
1
PLACE OF DEATH
No. 1 Sargent Terrace
.....
Registered No.
Received and filed AR 18
..... ........ 1942. 19
( Registrar)
Date of.
Of autopsy
none
What test confirmed diagnosis ?
Clinical
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(Give 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 he has attemled 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 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 bis death ... Cen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death aa 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 inarine corps of the I'nited 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 canse of death as nearly as he can state the saine. 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 bundred and fourteen, the word "war" shall include the China relief ex- pedition 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 Mexi- can horder 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 huried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case inay be, & satisfactory written statement containing the facts required by law to be returned and recorded, which shall he accompanied. in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required hy 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 physi- cian who is a member of the board of health, or employed by it or by the aclectmen 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 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-aix, that the deceased served in the army, navy or marine corps of the l'united States in any war in which it has heen 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 tices sary information which can be obtained as to the deceased, or as to the mauner or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
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 body is to he 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 Eilition).
Medical examiners shall make examination upon the view of the dead bodies of ouly such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the hody 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, Scc. G.
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 deatha 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 physi- cian is ahsent 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 in- directly 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 diseasc, and those of persons found dead.
Statement of Cause of Death .- Cause of death meana 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 discase 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 whose only occupation waa that of honie 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 bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
ORM R-301 A
is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of PARENTS 100m-2-'40-D-729-a
PLACE OF DEATH
Suffolk e (County) Winthrop (City or Town)
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.
50
...
2 FULL NAME
Baby Rex
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No .....
(Usual place of abode)
RTwoodside Que
ist
(If nonresident, give city or town and state)
Length of stay: In hospital or institution (Specify whether)
years
months
days.
In this community.
- yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
Female White
5 SINGLE
(write the word)!
MARRIED
WIDOWED
Or DIVORCED Jungle
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
march 9
1943
That I attended deceased from
0
1942
I last saw h ............
alive on
19 ..
, death is said to
have occurred on the date stated above, at. Immediate cause of death.
m.
Duration IMPORTANT 3-5-50
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
20 Was disease er injury in imy way related to occupation of deceased ?.
If so. specify ........
(Signed)
(Address) ..
Date .......
3/9
19 ........
21. Windho Winthings
Place of Burial, Cremation or Removal, DATE OF BURIAL March
(City or Town)
1942
22 NAME OF
FUNERAL DIRECTOR ..
ADDRES
147 Winthropst Winship
Received and filed
19
1910
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
42
Sa If married, widowed, or divorced" HUSBAND of (Give maiden name of wife in full)
(or) WIFE of.,
(Husband's name in full)
6 Age of husband or wife if alive.
.years
7 IF STILLBORN. enter that fact here. stillborn-
8 AGE Years Months ............ Days
If less than 1 day .Hours ........ .Minutes Due to.
Usual
9 Occupation :
Industry 10 or Business:
11 Social Security No ..... ......
12 BIRTHPLACE (City) Wantmet (State or country) mas
13 NAME OF
FATHER
Donald Red
14 BIRTHPLACE OF
FATHER (City) ........
Brooklyn
(State or country) 91. 9. C. ...
15 MAIDEN NAME
HER Rosalie Struthers
16 BIRTHPLACE OF MOTHER (City). Providence
(State or country) B.o.
17 Donald Rx
Relation, if any
Informant ... (Address) 21 Wordsile one Windhoek
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or/transit permit was issued: Www. D. Chil dress g (Signature of Agent of Board of Health pr other) Health Officer. 3/12/42
Guichard 16 What
(Registrar)
+
1
Winthrop Community hospital No ...
St.
S (If death occurred in a hospital or Institution, ¿ give its NAME instead of street and number)
(If U. S.
War Veteran,
specify WAR)
Lt
18 DATE OF DEATH March 9
Major findings: Of operations.
Of autopsy
not reported as yet
Date off
What test confirmed diagnosis ?.
M. D.
Due to.
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 dled. defined as required 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. Chap. 46, Sec. 9.
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.