USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1944 > Part 67
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by section ten of chapter forty-six, that the deceased aerved 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 board of health, or ins agent. upon receipt of such statement and certificate, shall forthwith countersign it and transmis 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 desth shall thereafter furnish for registration any other nece+ sary information which can be obtained as to the deceased, or ss to the mauler 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 ashee thereof which have been brought Into the commonwealth until he has re- ceived s 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 be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or burisl ground in which the interment is made. ... Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
Medical examiners shall make examiustion upon the view of the dead bodies of only such persons as are supposed to have 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 bouily llea aud take charge of the same; ... - General Laws, Chap. 38, Sec. 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 physlolans will certify to such deaths only as those of persons who, though disahled by recognized disease unrelated to any form of injury. have died without recent medical attenelance or whose phyaf- cian is ahsent from home when the certificate of death is needed.
(3) Medloal Examiners will Investigate and certify to all deaths sup- posably due to Injury. These include not only deaths ceused directly or in- directly hy traumatism ( Including resulting septicemia), and by the action of chemical (drugs or poisons), therins], or electrical agents, all deaths following abortion, hut also deaths from disease resulting from injury or Infeotlon 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 lying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causlug 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 la 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 ou account of the disease causing desth, report the usual occupation prior to illness. If the deceased had retired from husinesa, report the usual occupation prior to retirement. Children not gainfully employed may he returned aa at school or at hoine. For a woman whose only occupatiou waa that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terma, as housekeeper-private faniily, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
4 COLOR OR RACE
what
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Single
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.
AGE
8 25 Months .. Days
If less than 1 day Hours ...... .Minutes
Usual
9 Occupation :
nunce
Industry 10 or Business :..
11 Social Security No ....
Weatherstreet
12 BIRTHPLACE (City).
(State or country)
13 NAME OF FATHER For Solen. Gould
PARENTS
14 BIRTHPLACE OF FATHER (City) .... (State or country)
muster to obtain
2
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City) ....
(State or country) A
17 Fuss Ruck Buck
Relation, if any (Friend
Informant (Address) 300 Planaand-8h Winches Ma
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Gul Welke X
.... (Signature of Agent of Board of Health of other)
Malta Officer 10/5/44
(Official Designation) (Date of Issue of Permit)/
19 I HEREBY CERTIFY, That I attended deceased from
October 1934, to October 4
1944
I last saw her alive on Sept 26 19./4/., death is said to
Immediate cause of death Chronic myocarditis with left Ventricular failure.
Due to.
Due to.
Other conditions.
more.
(Include pregnancy within 3 months of death)
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 ?.... ......
If so, specify: 01 Buddy workingout M. D. (Signed). (Address). Winthrop Mass Date Get. 5,
1944.
21 ..
19 cantsteak Tarmont cover disk yerstory Place of Burial, Cremation or Removal. DATE OF BURIAL .. 1944
22 NAME OF FUNERAL DIRECTOR Celer. R. Bensin
ADDRESS
Received and filed OST : 1946 19
(Registrar)
100m-2-'40-D-729-a
CAUSE OF DEATH in plain 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.
R-301 A
PLACE OF DEATH
County)
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
1.97
I ...
§ (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Aattic E. Gould
(If deceased is a married, widowed or divorced woman, give also maiden name.) 300 Clement Street Wicetlust
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
C years
months days.
In this community/ yrs. X mos. x days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH. October 4 1944
(Month)
(Day)
(Year)
have occurred on the date stated above, at 8 a. .m. Duration IMPORTANT 10 years
Major findings: Of operations. none.
Date of.
Of autopsy.
none
What test confirmed diagnosis ?. Clinical
1
(City or Town) 94 Somesses ave watched! No. ....
(If U. S. War Veteran, pecify WAR).
(If nonresident, give city or town and state)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwitb, after the death of a person whom he has attended during bis last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnisb for registration a standard certificate of deatb, stating to the best of bis knowledge and belief tbe name of the deceased, his supposed age, the disease of which be died, defined as required by section one, wbere same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of bis deatb . .. Gen. Laws, Chap. 46, Sec. 9.
No undertaker or other person shall bury or otherwise dispose of a buman body in a town, or remove tberefrom a human body which has not been buried, until he bas 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 receiv- ing 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 tbe 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application make the certificate required of tbe attending physician. If death is caused by violence, tbe 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 re- moval of such body has been sooner obtained hereunder. If the deatb 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 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 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).
No undertaker or other person 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 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 sucb deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died witbout recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposabiy 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 electricai 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 inode of dying, e. g., beart failure, aspbyxia, 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 tbe 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 tbe 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 whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, bowever, designate tbe occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L., Chap. 46, Sec. 10, requires physicians to insert, a recital to that effect.
1
PLACE OF DEATH
Suffolk (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.
Registrar's No.
1.98
St.
§ (If death occurred in a hospital or institution,
{ give its NAME instead of street and number)
PHYSICIAN-IMPORTANT
2 FULL NAME.
Albert Irving Mudgett
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
108 Taft Ave ..
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
Hospital
years
15
days.
In this community
10 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED Single
or DIVORCED
18 DATE OF
DEATH
October
5
1944
(Month)
(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 fact here.
8
53
AGE
Years
Months.
Days
If less than 1 day
Hours ..........
Minutes
Usual
9 Occupation :
Broker
Industry
10 or Business:
Stock
11 Social Security No.
Belfast
12 BIRTHPLACE (City)
(State or country)
Maine
13 NAME OF
FATHER
Albert Leslie Mudgett
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
Prospect
15 MAIDEN NAME
OF MOTHER
Evelyn Hawkins
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Maine
Waldo
17 Frank Mudgett Brother
Informant.
(Address)
Portland Maine
was filed with me BEFORE the byrfal or transit permit was issued: I HEREBY CERTIFY that a satisfactory standard certificate of death
22 NAME OF
FUNERAL DIRECTOR
John F. Ornaley
ADDRESS
Winthrop Mass
(Signature of Agent of Board of Health or other),
10/6/44.
(Official Designation) (Date of Issue of Permit)
Major findings:
Of operations.
Date of
Of autopsy.
What test confirmed diagnosis? Laboratory Lyans
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 ? No
If so, specify Edwards tranger.
(Signed)
M. D.
(Address) 200 Wastymito Date Oct. 5 1944.
21 Woodlawn Everett
Place of Burial, Cremation or Remevale
(City or Town)
DATE OF BURIAL October: 7, 1944
19
Received and filed.
OCT 9- 1944
19
(Registrar)
X
4%
I last saw h IM
alive on
October 4, 1944 death is said to
have occurred on the date stated above, at 4.35 A.M.
Immediate cause of death
MyologeNous LEUKEMIA
Duration
IMPORTANT
7 Mos.
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
PARENTS
50m-(e)-3-43-11574
No. Winthrop Community Hospital
(Was deceased a
U. S. War Veteran,
r
if so specify WAR)
(Give maiden name of wife in full)
19 I HEREBY CERTIFY,
That I attended deceased from
May 4
.- ,
44.
ţo.
October 5
19.
19
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registercd 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 re- quired hy section one, where samnc was contracted, the duration of his last illness, when last scen alive hy 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 helief, served in the ariny, 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 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 fourtcen, the word "war" shall include the China 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 horder service of nineteen hundred and sixteen and nine- teen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human body in a town, or remove therefrom a human body 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 there is no such hoard, 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 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 he, a satisfactory written statement containing the facts required by law to he 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 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 physi- cian who is a member of the hoard of health, or employed hy it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused hy 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 ahove 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 hody has been sooner obtained hereunder. If the death certificate contains a recital, as required
by scction 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 appcar 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 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).
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 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).
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died hy 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 hody lies and take charge of the same; .. . - Gencral Laws, Chap. 38, Sec. 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 hedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such dcathis only as those of persons who, though disabled hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose phy- sician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posahly due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), 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 mcans 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 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 he 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, ctc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
1
PLACE OF DEATH
Sulfolk KCoppty) Winthrop (City or (rywh) 44 Fairview It
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.
Registered No.
199
§ ( It death occurred in a hospital or institution, give Its NAME Instead of street aud nuniber) PHYSICIAN - IMPORTANT
2 FULL NAME
( If deceased is a married widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
44 Taufview
(Usual place of abode)
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