USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 11
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Suffolk (County)
.Winthrop (City "or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registered No.
32
(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
S
2 FULL NAME ... Carolyn Fleming
(If deceased is a married, widowed or divorced woman, give also maiden name.)
.St.
Winthrop Moss
(a) Residence. No .. 56 ... Court Road
(Usual place of abode)
length of stay : In hospital or institution
(Specify whether)
months
I7
days.
In this community
2℃
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCEDMarried
5a If married, widowed, or divorced
HUSBAND of
John (Gpe majet eamd of gife in full)
(or) WIFE of
(Husband's name in full)
6.7
.years
7 IF STILLBORN, enter that fact here.
ÅGE
Years ..
Months.
.Days
If less than I day
Hours
.Minutos
Usual
9 Occupation:
Housewife
Own Home
1I Social Security No.
Lawrence
12 BIRTHPLACE (City)
(State or country)
Mass
13 NAME OF
FATHER
Charles S, Sargent
14 BIRTHPLACE OF
FATHER (City)
Lawrence
(State or country) Mass
15 MAIDEN NAME
OF MOTHER
Matilda Thorne
16 BIRTHPLACE OF
MOTHER (City)
Philadelphia
(State or country)
Pa.
17 Inlorman ohn T. Fleming
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit pormit was issued: Wani S. Childerst .....
(Simature of Szent of Board of Health or other) Healite Officer 2/2/45
(Official Designation) (Date of Issue of Permit)/
18 DATE OF
1945
(Month)
(Day)
('Year)
19 | HEREBY CERTIFY, That I attended deceased, from
Mar. 1
I last saw her ....... alive on
Feb. 1
19.44
death is said
to have occurred on the date stated above, af ..:. 20 .A.m.
Immediate cause of death.
Carcinom tosis
Duration
...
2 yrs. R ...
Due to
Duc to
Other conditions
.......
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of ..
Of autopsy ..
What test confirmed diagnosis ?
PHYSICIAN Underline the cause to which death should be charged sta- tistically.
20 Was disease or lejory In any way related to eccopatioe of deceased ? NO
If so, specify
-Enered Je tranger
(Signed)
. Fraunque
M. D.
(Address) 200 Ul andmed By the Date 122 2 1945
21 Woodlawn
Place of Burial, Cremation or Removal DATE OF BURIAL
Feb. 5, 1945,00
-(City or Town)
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Received and filed .........
A TRUE COPY ATTEST:
(Registrar)
(.Sargent.)
(H U. S.
War Veteran.
specify WAR)
(If nonresident, give city or town and state)
years
MEDICAL CERTIFICATE OF DEATH
6 Age of husband or wife if alive.
(write the word)
DEATH
Feb. 2
1944 .... , to .... Feb, 1
Everett
Relation, if any
Husband
(Addres:55 Court Rd, 6, 7
No ... Winthrop Community Hospital
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 tbc 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 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.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a buman body which has not been buried, until he has received a permit from the board of health or its agent appointed to issuc such permits, or if there is no such board, from the clerk of the town where the person dicd ; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from onc 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 dc- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, 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 pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violence, the medical exam- iner 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 a 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 certificatc, 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
obtained as to the deceased, or as to the manner or cause of the deatb, 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 funcral 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 observ- 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 bedside care during a last ill- ness 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 un- related to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is ncedcd.
(3) Medical Examiners will investigate and certify to all deatbs supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting scptice- mia), 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 occupa- tion, the sudden deaths of persons not disabled by recognized disease, and tbosc 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 discase causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupalion .- 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 busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman wbose only occupation was that of home bousework, 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
RM R-302
SUFFOLK BOSTON
The Commonturalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON
(City or town making return)
1147
33
St.
(If death occurred in a hospital or institution,
3
give its NAME instead of street and number)
2 FULL NAME
Fredrick W Alexander
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe. No. 30 Emerson Rd
St.
Winthrop
Mas.s
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution ..
(Before death)
Hosp.
-
years
months
6
days.
In this community
9
yrs.
mos.
-
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
M
4 COLOR OR RACE
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced
HUSBAND of
Geraldine ...
.Moore
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive 43
years
7 IF STILLBORN, enter that fact here.
8
61
AGE
Years
Months.
Days
If less than 1 day Hours Minutes
Usual
Purchasing Agent
9 Occupation :
Industry
United Consumers Inc. Boston
10 or Business :
11 Social Security No ....
Unknown
12 BIRTHPLACE (City)
(State or country)
East ..... Boston
Mass
13 NAME OF
FATHER
William Alexander
PARENTS
14 BIRTHPLACE OF
3
FATHER (City)
(State or country)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Elliott
16 BIRTHPLACE OF
?
MOTHER (City)
(State or country)
Ireland
Relation, if any
17 Mrs.Geraldine .... Alexader. ( .... Wifa (Address) 30 Emarson Rd. Winthrop
A TRUE COPY.
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED 19
18 DATE OF
DEATH
Feb
3
(Month)
(Year)
(Day)
That I attended deceased from
19 | HEREBY CERTIFY,
Jan 29
19 ..
45
to
Feb
3
.4.5
I last saw h.im
....... allve on
Feb ........ 3 .... , 19 ... 45 death Is sald to
have oocurred on the date stated above, at. 3,50 .m.
Duration
Immedlate cause of death Lobar Pneumonia, Left Lower &
Days
Upper Lobes (Type Unknown)
Rheumatic Heart Disease
Aortic Stenosis&Insufficiency
Yrs.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of
should be charged sta- tistically.
Of autopsy
As .... Above
What test confirmed diagnosis?
20 Was disease or Injury In any way related to ocoupatlon of deceased ?...
No
If so, specify
(Signed) .... William .R.
.. Duden
(Address) P .. B.Brigham ... HospitalDate.
M. D.
2 /3 19 45
Woodlawn
Everett Mass.
21 "PLACE OF BURIAL,
CREMATION OR REMOVAL
(Cemetery)
(City or Town)
DATE OF BURIAL
2/6
19
45
22 NAME OF
FUNERAL DIRECTOR
Stookwell Funeral House,
ADDRESS Peabody .... Mass
John ...... Dunn
2/7
19 45
Received and filed
MAR" 3"
1945
(Registrar of City or Town where deceased resided)
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
50m (e)-1-41-4667
PLACE OF DEATH
(County)
1
(City or Town)
No.
..
Peter Bent Brigham Hospital
Registered No.
....
(If U. S.
War Veteran,
specify WAR)
No
(Specify whether)
1945
(Give maiden name of wife in full)
Underline the cause to which death
Autopsy
R-301 A
extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to Insert a recital to that effect. PARENTS
100M-6 - 2-42-8855
I HEREBY CERTIFY that a satisfactory standard certificata of death was filed with ma BEFORE the burial or transit permit was Issued : Wmstabuldrer
(Signature of Agent of Heard of health or other)
-Feb-3/As
....... (Omclal' Dealgnation) ( Date of Issue of Permit)
18 DATE OF
DEATH
February
3.
1945
( Month )
(Day)
(Year)
19 | HEREBY CERTIFY, That I attended deosased from
19 .. 55 ......
DEC - 22
Ło
February 2.
19.416 ...
I last saw h = \" alive on.
February 2, 191/5, death is said to
have occurred on the date stated above, at
6 - 25 A
... m.
6 Age of husband or wife if alive
years
9 IF STILLBORN. enter that fact here.
8 AGE 65 Years
Months
Days
If less than 1 day Hours. Minutes
Usual 9 Occupation :
Industry 10 or Business :
11 Social Security No.
*2 BIRTHPLACE (City)
(Siate or country)
Montrealla
13 NAME OF
FATHER
Wand Mandelson
14 BIRTHPLACE OF
FATHER (City) ( State or country)
sia
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
17 Informant ( Address)
ation, If any
i'lace of Burial, Cremation Q Removal. (City or Town)
DATE OF BURIAL
19
22 NAME OF
FUNERAL DIRECTOR ...
ADDRESS
10-
Reoalvad and Alad
19.
....
Due to.
Due to.
Other conditions. Chronic Arthritis Deformans. ( Include pregnancy within 3 months of death)
3 gm.
IMPORTANT Physician
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis ?.
0 Was disease or injury in any way related to occupation of deceased? IVO
80, specify ...
(Signed) Clients
Frances M. D.
194.5
21
Written
(Address) 200 Washere .Date ....... Correct
Duration
Immediate cause of death. Chronic Endocarditis-
IMPORTANT
3 SEX
4 COLOR OR RACEI firmale white
5 SINGLE
MARRIED
WIDOWEDU
or DIVORCED
(write the word)
5a If married. widowed, or divorced HUSBAND of
(or) WIFE of
Placedog pavien
( Husband's name in full)
to
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
-
years
months days.
In this community
20 yes.
mos.
dayı.
(Specify whether)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Parle
To be filed for burial permit with Board of Health or its Agent.
34
S ( If death occurred in a hospital or institution, St.
{ give its NAME instead of street and number)
2 FULL NAME
PLACE OF DEATH
00 Suffolk ...... (County)
......
1
No.
(City or Town) 28-Thou
Rebecca
Lavier
(If deceased is a married, widowed or divorced woman, give alao maiden name.)
(a) Residence. No. (Usual place of ahode)
28-Juan
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
touttungs
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
( Registrar)
Underline the cause to which death should ba charged sta. tistically.
ank
Registered No.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medloal offioer shall forthwith, after the death of a person whoin he has attended during his last illness, at the request of an undertsker 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 bebel the nante of the deceased. lis supposed sge, 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 aeen alive hy the physician or officer and the date of hia death .. . Gen. Laws, Chap. 46, Sec. 9.
N physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and lour- teen, shall, if the decessed, to the best of his knowledge and helief, 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 s recital to that effect, speci- fying the war. sud shall siso certify in such certificate hoth the primary and the secondary or iinmediate 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 thia sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen. the word "war" shall include the China relief ex- 'pedition and the Philippine insurrection, which shall, for said purposea, he deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two; and the Stexi- 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 hury or otherwise dispose of a human body in a town, or remove tlierefrom a human body which has not been buried, until he has received a permit from the board of health, or ita agent appointed to lasue such permits, or if there is no such board, from the clerk of the town where the person died; aud no undertaker or other person shall exhume a human body and remove it from a town, from one cenietery to another, or from one grave or tomb 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 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 he returned and recorded, which shall be accompanied. in case of an original interment, by a satisfactory certificate of the attending physician, if any, aa 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 hoard of health, or employed by it or hy the aelectinen for the purpose, shall upon application niake the certificate re- quired of the attending physician. If death is csused by violence, the medl- cal examluer shall make such certificate. If such a permit for the removal of a liumsn hody, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall 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 hody has been sooner ohtalued hereunder. If the death certificate containa a recitsl. 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 certilying the cause of death shall therealter furnish for registration any other neces sary information which can be obtained as to the deceased, or as to the manner of 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 ashea thereof which have been brought Into the commonwealth until he has re- ceived a permit so to do from the haard of health or its agent appointed to issue such perinits, 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 he held, or from a person appointed to have tbe care of the cemetery or burial ground in which the intermeut is made. .. . Chap. 114. Sec. 46. G. L., (Tercentenary Editiou).
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 body of such a person, he shall forthwith go to the place where the hody lies aud take charge of the same; . .. - General Laws, Chap. 38. Sec. 6.
RULES OF PRACTICE
The fulfillment of the purpose of these lawa calla 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 physlolana will certify to such deaths only aa those of persons who, though disahled 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) Medloal 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 septicemla). and by the action of clientical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or Infection related to occupation, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of deatlı means the disease, or complication which causes death. not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. Aa principal cause name the disease caualng 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 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 he returned aa at school or at hoine. For a woman whose only occupatiou was that of home housework, write bousework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terma, aa housekeeper-private family, cook-hotel. etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-301 A
PLACE OF DEATH
Suffolk U (County) Winthrop
(City, or Town) 25 Washington avenue No.
The Commonforall of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial pormit with Board of Health or its Agent.
Registered No.
35
( It death occurred in a hospital or institution, give its NAME instead of street and number)
( Coburn)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residenca.
No.
125 Washington Live
(Usual place of abode)
Length of stay: In hospital or Institution
(Refore desth)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
white
5 SINGLE
( write the word)
Willowed
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
El (Give maiden name of wife in full)
Vaicon
( Husband's name in full)
6 Age of husband or wife if alive
years
> IF STILLBORN. enter that fact here.
8 AGE 16 Years 11 Months 24 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
at home
11 Social Security No.
12 BIRTHPLACE (City)
Barbara County
(Siate or country)
West Virginia
13 NAME OF
FATHER
Marshall Coburn
14 BIRTHPLACE OF
FATHER (City)
Barbero County
(State or country)
West Virginia
15 MAIDEN NAME
OF MOTHER
Columbia arnold
16 BIRTHPLACE OF
MOTHER (City)
Barbour County
(State or country)
West Virginia
Relation, if any
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