USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1942 > Part 41
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Married, Single,
Widowed or Divorced
Single
Name of husband or wife
Age of husband or wife, if alive
Birth date of deceased: Year 18.9Month. .... Day ........
Age: Years.
52 Months .................. Days .......
.......
If less than
one day
hr
„minutes.
Birthplace
Cambridge ,Mass.
(City, town or county)
(State or foreign country)
Usual occupation
Architect
Industry or business
Building
Father: Name
Peter Hovgaard
Occupation
Birthplace
Denmark
(City, town or county)
(State or foreign country)
Mother: Maiden name Magda Natalie Mich-
äök
Birthplace
Norway
(City, town or county)
(State or foreign country)
Name of informant Magda N. Hovgaard
Date of death: Mon July Day. 1 Year_1942
Immediate cause of death
Cerebral Hemorrha
Duration 25 minse
Dun to Arterio Sclerosis 11
(City or town making return)
Registered No ..
1.92
...
death occurred in a hospital or institution, its NAME instead of street and number)
(If U. S. specify WAR)
(If nonresident, give city or town and state)
n this community
yrs.
mos.
days.
CERTIFICATE OF DEATH
(Day)
(Year)
RTIFY, That I attended deceased from
19 ........ , to .......
19.
...
19
death is said
: stated above, at ........
...........
Duration
months of death)
PHYSICIAN
Date of.
Underline the cause to which death should be charged sta- tistically.
sd to occupation of deceased ?
M. D.
Date.
19
or Removal.
(City or Town)
19
19
(Registrar)
1 PLACE OF DEATH No ... 3 SEX (or) WIFE of 3 AGE Years Usual 9 Occupation: Industry 10 or Business: 13 NAME OF FATHER PARENTS 17 Informant. (Address) 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 (State or country)
200m-10-'39. No. S427-d
nosis ?
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 regis- tration 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 illness, 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 shall hury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not been huried, until he has received a permit from the board of health or its agent appointed to issue such permits, or if therc is no such board, from the clerk of the town where the person died ; and no undertaker or other person shall exhumc a human hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving 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 clerk of the town where the body is huried. No such permit shall be issued until there shall have heen de- livered to such hoard, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required hy law to be returned and recorded, which shall be 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 insufficient, a physician who is a member of the hoard of health, or employed hy it or hy the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused hy violence, the medical exam- iner 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 he obtained early enough tor the purpose, the certificate of death made as ahove provided and in the possession of the undertaker desiring to make such a removal shall constitute a permit for such removal ; provided, that such hody 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 hcen sooner ohtained hereunder. If the death certificate contains a recital, 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 heen engaged, such recital shall appear upon the permit. The hoard 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 fur- nish 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 Merk 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 hrought 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 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 ohserv- ance 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 ill- ness from diseasc unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease un- related 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 supposably due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septice- mia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deathe 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 morhid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, 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 husi- ness, 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, 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
DEPARTMENT OF COMMERCE BUREAU OF THE CENSUS
STANDARD) CERTIFICATE OF DEATH
State File No. Registrar's No.
State of
1. PLACE OF DEATH:
(a) County
(6) City or town
Kittery
(e) City or town
Winthrohe
(If outside city or town limita. write BUPL)
(c) Name of hospital or institution:
(d) Street No.
42 Pleasant ParkRd
(If rural, give location)
(d) Length of stay: In hospital or institution
In this community
years, months or days)
1 day
() If foreign born, how long in U. S. A .? years.
3. (a) FULL NAME Larry Michael Hougaard Date of death: Month July
MEDICAL CERTIFICATION
3. (b) If veteran,
name war
3. (c) Social Security No. 002-01-9223
I hereby certify that I attended the deceased from
19
.zapto
19
4. Sex
race
20
6. (b) Name of husband or wife
6. (c) Age of husband or wife it | and that death occurred on the date and hour stated above.
alive years Imrocompte cause of death Total hemorrhage.
7. Birth date of deceased
1890
(Day) (Year
8. AGE:
Years
52
Months
Days
If less than one day
-
hr mın!
9. Birthplace Cambridge mace
Due to
10. Usual occupation
11. Industry or business Building
MOTHER FATHER
13. Birthplace
Denmark
Major findings:
14. Maiden name Pagola natalie Michack Of operations
15. Birthplace
(City/tonn. or county) (State or foreign country)
Of autopsy
16. (a) Informant's own signature Magda h. for tougame
22. If death was due to external causes, fill in the following:
17. (a) Burial (6) Date thereof July 7 1942 (a) Accident, suicide, or homicide (specify)
(c) Place; burial or cremation
(Burial, cremation, or removal) Wingao final (b) Date of occurrence
Where did injury occur?
18. (a) Signature of funeral directot. Charles T. Beni
(b) Address ninthopm
(d)] Did injury occur in or about home, on farm, in industrial place, in public place?
(Specify typs of place)
19. (a) 7/6/42 (b) Burnell 6. trick . beer3. Signature.
6.6. Shapleigh (M. D. or other) M.D
(Date received local registrar)
(Registrar's signature)
HI Address Jittery nye. Date signed
8-6917
U. S. GOVERNMENT PRINTING OFFICE 16-13493
day
yea 942/
minute
5. Color or
6.(a)Single, widowed amied,
divorced
that I last saw h .. __ alive on 19
Duration
سيميركا ط
Due to arteriosclerdei.
Other conditions.
(Include pregnancy within 3 months of death)
PHYSICIAN
12. Name Peter Hlougaan
(tate or foreign country).
Underline the cause to which death should be charged sta- tistically.
(b) Address.
(City or town) (County) (Stato)
While at work? (e) Means of iniupy
224
Name
2. USUAL RESIDENCE OF DECEASED: (a) State Park (b) County Suffolk
(If outside ofy or town limits. write RURA
(If not in hospital or institution, write street number or location)
(Specify whether
(Month)
(City. town. of county)
RM R-302
1
PLACE OF DEATH
Middlesex
(County)
The Commonlocalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
Lexington (City or town making return)
Registered No.
183
.....
Medie aTo@ Surgical Building -- 2 5 (If death occurred in a hospital or institution, No. Metropolitan ... State .... Hospital St. ¿ give its NAME instead of street and number)
2 FULL NAME
Phyllis Corinha
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S. War Veteran, specify WAR)
(a) Residenoe. No.
Corinha Beach
(Usual place of abode)
Winthrop, Mass.
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
months
1
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE!
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or_divorced HUSBAND of
(or) WIFE of
== JA(Give maiden name of 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
23
AGE
Years
8 Months.
4
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
None
Industry
10 or Business :
None
Il Social Security No ..
None
12 BIRTHPLACE (City)
Winthrop
(State or country)
Massachusetts
13 NAME OF
FATHER
Joseph Corinha
14 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Philomena Perry
16 BIRTHPLACE OF
MOTHER (City)
Cannot .learn
(State or country)
17
Walter E . Fernald &
Relation, If any
Informant
(Address)
Waverley, Massachusetts
"records )
A TRUE COPY.
James J. Carroll
ATTEST:
Registrar of duty or town where death occurred)42
DATE FILED
July 11,
19
18 DATE OF
DEATH
July 5, 1942
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
July ..... 4.
19
42,
July 5,
19 ..
.42
I last saw hof
.alive on.
July 5, 19 42 death Is sald to
have occurred on the date stated above, at
2:35 p.
.m.
Duration
Immediate cause of death
Mesenteric Thrombosis and
July3/42
Intestinal Obstruction
July3/42
Due to.
Volvulus
July3/42
Due to
Other conditions.
(Include pregnancy within 3 months of death)
Major findings :
Same as above
Of operations
Date of ..
July4/42
Physician Underline the cause to which death should be charged sta- tistically.
Of autopsy
Same
as above
What test confirmed diagnosinico-patho-
No
20 Was disease or injury in any way related to occupation of deceased ?.
Richard C Cooke
(Signed)
If so, speolfy
Metropolitan State Hospital
(Address)
Waltham
Mass.
Dat
July 5 42
21 PLACE OF BURIAL,
Winthrop, Winthrop
CREMATION OR REMOVAL
(Cemetery)
July 7,
(City or Toyaz
0
DATE OF BURIAL
22 NAME OF
Kirbey Bros
FUNERAL
218 Winthrop St., Winthrop,
ADDRESS
JUL 1 3 1942
19
Received and filed
(Registrar of City or Town where deceased resided)
50m (e)-1-41-4667
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.) resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
PARENTS
Portusstate School
Lexington
CERTIFICATE OF DEATH
Metropolitan
Years
R-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
114 Winthrop Street
The Commonforalth 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.
124.
f ( If death occurred In a hospital or Institution, St. [ give its NAME instead of street aud number )
2 FULL NAME Augustus Lorimer Hodgkins
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
114 Winthrop Street
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
years
months days.
In this community
20rs ..
mos.
day
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Ma le
4 COLOR OR RACEJ
White
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Married
Sa If married,
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
( Ilsband's name in full)
6 Age of husband or wife if alive 79
years
7 IF STILLBORN. enter that fact here.
8 76
AGE
Years
6
Months
7
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Sea Captain (Retired)
Industry
U S Goverment
10 or Business :
11 Social Security No. None
Ellsworth
12 BIRTHPLACE (City)
(State or country)
Maine
13 NAME OF
FATHER
William W Hodgkins
14 BIRTHPLACE OF
FATHER (City)
Ellsworth
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Charlotte Bonsey
16 BIRTHPLACE OF
MOTHER (City)
Ellsworth
(State or country)
Maine
17 Lettie Hodgking
Helafi@, if any
Informant.
114 Winthrop St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the bugial or transit permit was Issued :
.......
(Signature of Agent & Board Health Officer 7/14/45
(Date of Issue of ,& ermit)
18 DATE OF
DEATH
(Month Y
(Day)
(Year)
19 | HEREBY CERTIFY,
19.
That I attended deceased from
July 11
19
last saw K ............... alive on 46411 15 death Is said to have occurred on the date stated above, At 10.20 Pm
Immediate cause of death.
Duration IMPORTANT .......
Due to.
arturo Mluví
Due to.
Chateaustit
Other conditions.
(Include preguancy within 3 months of death)
IMPORTANT
Physician
l'nderline the cause to which death should be charged sta. tistically.
20 Was disease or injury in any way related to occupation of deceased ?
If so, specify.
(Signed)
(Address) YWashington.at
Date 7-13-1942
21 winthrop winthrop
l'lace of Burial, Cremation or Removal.
(City or Town)
July
15
5+2
DATE OF BURIAL
22 NAME OF
Howard Sprynolds
FUNERAL DIRECTOR
ADDRESS
....
of health or other
Received and filed
WL 17
1942
1
.19
(Registrar)
terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and
extracts from the laws on back of certificate.
100m (d) -1-41-4667
if deceased was a U. S. War Veteran, G. L. Chap. 46, Seotion 10, requires physicians to insert a recitai to that effect.
PARENTS
Major findings :
Of operations.
Date of.
Of autopsy
What test confirmed diagnosis ?
M. D
.... (Official Designation)
MEDICAL CERTIFICATE OF DEATH
1942
11
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Registered No.
5
No.
(Specify whether)
pet eradgyorcedWilliams ).
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 atteinled during his last illness, at the request of an umlertaker 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 bia 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 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 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 inchide the China relief ex- pedition and the Philippine insurrection, which shall, for said purposea. he deemed to have taken place hetwcon February fourteenth, eighteen hundred and ninety-eight and July fourth. nineteen hundred and two, and the Mexi- can 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 internient. by a satisfactory certificate of the attending physician, if any, as required by law, o1 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 physi- cian who is a member of the board of health, or employed by it or hy the aelectmen 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 & permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained carly 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, unlesa a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, aa required
by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the I'nited States in any war in which it has been engaged. sucb 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 furni,lr for registration any other neces- sary information which can he obtained as to the deceased, or as to tbe 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 he has re- ceived a permit so to do from the board of health or its agent appointed to issue such perinits, or if there is no such hoard, from the clerk of the town where the body is to be buried or the funeral is to be held, or front 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).
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, Scc. 6.
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 physi- cian is absent from home when the certificate of death is needed.
(3) Medioal 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 aepticemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 varioua 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 was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, as housekeeper-private family, cook-hotel, etc. For a person who had no occupatiou whatever write none.
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