USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1945 > Part 22
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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 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 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
01 A
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.
61
St. § (If death occurred in a hospital or institution, { give its NAME instead of street and number) PHYSICIAN-IMPORTANT
2 FULL NAME
Helen M (Richardson) Dodge
(If deceased is a married, widowed or divorced woman, give also maiden name.)
if so specify WAR)
(a)
Residence. No.
41 Temple Ave.
Winthrop
_St.
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution.
years
1
months
days.
In this community
40yrs.
mos.
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDWidowed
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
Frank Dodge
{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
84
AGE
Years
9
Months.
Days
If less than 1 day
Hours.
Minutes
Usual
9 Occupation :
Dress Maker (Retired)
Industry
10 or Business:
Self
11 Social Security No.
None
12 BIRTHPLACE (City)
(State or country)
Providance
R.I.
13 NAME OF
FATHER
Charles Richardson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
R.I.
Providence
15 MAIDEN NAME
OF MOTHER
Hattie Tucker
20 Was disease or injury in any way related to occupation of deceased If so, specify -
(Signed).
(Address) 56 2 BlwilayDate 3/21/54
21
Swan Point
DATE OF BURIAL
Providence R.I. (City or Town) 19 45
Place of Burial, Cremation or Removal.
March 24
was filed with me BEFORE the burial or transit permit was issued : I HEREBY CERTIFY that a satisfactory standard certificate of death unktebliress
(Signature of Agent/of Board of Health or other) mar. 23/45
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
March
21
(Month)
(Day)
1945
(Year)
19 I HEREBY CERTIFY
February 18 9 45
to
March 21
13
That I attended deccased from
45
I last saw h
en
alive on
March 2/1945, death is said to
have occurred on the date stated above, at.
7:30pm
Duration IMPORTANT
Immediate cause of death acute pulmonary
Infarct
3 days
Due to.
artenschematic
gangrène left foot
1 month
Generalized artenisateurs 1 year none
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings:
Of operations
none
Date of ..
Underline the cause to which death should be
Of autopsy
una
What test confirmed diagnosis!
clinical x lab
chargerta rtistically.
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
Nantucket
17 Informant5
Relation, if any
Frederick Austin (Brother[Law) (Address) 10 Wayne Ave. Ipswitch
22 NAME OF
Howard SThunold
FUNERAL DIRECTOR
ADDRESS
19
Received and filed. MAR 2 9 1945
(Registrar)
50m-(c)-3-43-11574
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. PARENTS
No. Winthrop Community Hospital
Registrar's No.
(Was deceased a
U. S. War Veteran,
(Usual place of abode)
2
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 deccased, 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 hc died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last scen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the sceondary 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 fourteen, the word "war" shall include the China relief cxpedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nine- teen 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 becn 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 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 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 physi- eian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate 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 iorty-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 neces- sary information which can he 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 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).
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 lics and 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 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 phy- sician is absent 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 indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deathis of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Canse of death means the disease, or complication which causes death, not the inode 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 disease causing death, report the usual occupation prior to illness. If the deceased had retired from husiness, 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, how- ever, 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
01 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 85 Main Street
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.
62
[ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Mary (Grant) Gentle
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
85 Main Street
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
months
days.
In this community29 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 DIVORCEDMarried
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Norman Gentle
(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
AGE_60Years.
4
Months.
8
Days
If less than 1 day
_Hours ..._....
Minutes
Usual
9 Occupation:
Housewife
Industry
10 or Business:
At Home
11 Social Security No. None
Glasgow
12 BIRTHPLACE (City)
(State or country)
Scotland
13 NAME OF
FATHER
Robert Grant
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Marion Reid
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
17 Norman Gentle
Informant (Address) 85 Main Street Winthrop
was filod with me BEFORE the bufial or transit permit was issued: I HEKEBY CERTIFY that a satisfactory standard certificate of death
(Signature of Agent of Board of Healthyor other)
3/26/49
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
march
24
1945
(Month)
(Day)
(Year)
19, I HEREBY CERTIFY,
4$
to March 24
19.
45
last saw her alive on March 2 3, 1945, death is said to
have occurred on the date stated above, at.
5 0 A.M.
Duration
Immediate cause of death.
IMPORTANT
Carcinoma of rectosigmoid 14.4 months
Due to.
Due to.
4 mar generalized Carcinomatorio
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT Physician
Major findings:
Of operations.
Carcinoma of fecto-
Underline
sigmond
Date
of fameary 24 the Cause to
which/death
Of autopsy.
none
should be
What test confirmed diagnosis
Clinical + Favorables sta. ftistically.
20 Was disease or injury in any way related to occupation of deceased ?. (0 If so, specify. (Signed) Maurice Traunsteine 1 ML M. D.
(Address) 562 Shirley CP Dite March 26 1945
21
winthrop
Winthrop
Place of Burial, Cremation or Removal,
March
26
19.4.5
DATE OF BURIAL.
22 NAME OF
Howard Soumolto
FUNERAL DIRECTOR
ADDRESS
Winthro Freue.
Received and filed. 713 2 7 1945
19
(Registrar)
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. PARENTS
50m.(e)-3-43-11574
No.
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
1
(City or Town)
That I attended deceased from
60
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as 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 his death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deccased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both 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 fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and ninc- teen 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 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 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 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 physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate 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-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 neces- sary information which can be obtained as to the deceased, or as to the inanner 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 perinit 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).
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, 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 physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any forin of injury, have died without recent medical attendance or whose phy- sician is absent 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 indirectly hy traumatism (including resulting septicemia), 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 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 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 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, how- ever, 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
M R-302 1
1
PLACE OF DEATH
Hampden (County) Westfield
(City or Town)
No. Westfield State Sanatorium
The Commonincalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Westfield
(City or town making return)
63
St. give its NAME instead of street and number) -
Michael Hines
(If deceased is a married, widowed or divorced woman, give also maiden name.)
St.
Winthrop,
Mass.
(If nonresident, give city or town and State)
Hospital
2
months
years
5
days.
In this community
yrs.
2
moa.
5
days.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
(write the word)
DEATH
March
24
1945
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
That I attended deceased from
Jan. 19
194.5.
March 24
to.
19.
.. 4.5
I last saw h
im
Mar.
alive on.
24
19 ... 4.5 death Is sald to
have occurred on the date stated above, at
2:23 A
.m.
Immediate cause of death.
Pulmonary tuberculosis
7
mos
Due to.
Due to
17 .... das.
Other conditions.
Acute appendicitis and
Physician
(Include pregnancy within 3 months of death)
thrombosis of popliteal artery Underline
Major findIngs:
with dry gangrene.
Of operations.
No.operations
Date of
the cause to which death should be charged sta- tistically.
Of autopsy.
s.e.e ..... a.bo.ve
What test confirmed diagnosis? X-ray & sputum 20 Was disease or injury In any way related to occupation of deceased?
No.
If so, specifyp ......... "Goodhue
(Signed)
(Address) I'd. State San.
M. P.
21 PLACE OF BURIAL,
Winthrop Cemetery
CREMATION OR REMOVAL ..
Winthrop . Ma.s.s
(City or Town)
DATE OF BURIAL
{Cemetery)
arch
27
19
45
A TRUE COPY.
Harold Whitemore
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
April ..... 2
19 45
Received and filed.
1545
(Registrar of Clty or Town where deceased resIded)
X
2 FULL NAME
(a) Residenoe. No.
15 Whittier
(Usual place of abode)
Length of stay: In hospital or Institution.
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