USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 32
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If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify : (1) Under cause its known or presumable nature; and (2) under manner, indicate the circum- stances leading to medico-legal inquiry. For example : "Hemorrhage spon- tancous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
301 A +
1.
2 FULL NAME.
( If deceased is a married, widowed nr divorced worlaz, give also maiden name. )
220 Leallage Pulk Road
St.
( If nonresident, give city or town and State)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
mntiths days.
In this community 40 yra.
mon.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male White
5 SINGLE
«write the word)
kramid
MARRIED
WIDOWED
or DIVORCED
5a 1
HUSBAND of
dewetce divorced mc Laughlin
(or) WIFE of
( Husband's name In full)
6 Age nf husband or wife if alive
6.5
years
7 IF STILLBORN, enter that fact here.
AGE
8 61 Years Months Oays
If less than 1 dey
Hours
Minutos
Usual
9 Occupation :
Roofer
Industry
10 or Business :
Prop.
11 Social Security No. Cannot te Learned
12 BIRTHPLACE (City)
Fartar grace
(State or county newfoundland 77 95
13 NAME OF
FATHER
ER
John Hrough
14 BIRTHPLACE OF
FATHER (City)
(State or country )newfoundland 71 Fr
15 MAIDEN NAME
OF MOTHER
Julia Purcell
16 BIRTHPLACE OF
MOTHER (City)
Harlan brace
(State of country) Newfoundlandny .Fr.
17 Ellen Herush
Relayou Yang
Informant ( Address ) 220 Central Park Road
I HEREBY CERTIFY, that a satisfactory standard certificate of death was filed with me BEFORE the punta de transit permit was issued:
( Signature of Agent of Board of Health he other)
Jache 0 5/2/46
( Date of Issue of Permit)
18 DATE OF
DEATH
30
1946
(Month )
( Day)
(Year)
19 | HEREBY CERTIFY. That 1 attended deceased from
april 6
19 46, to
april 36
19
i last saw ham alive on
app 90, 19 th death is said to
have occurred on the date stated above, at
m.
Duration
Immediate oouse of death. Branche pneumo
IMPORTANT
4/26/46
RV Hemiplejia -
Due to
1940
Other conditions ..
( Include pregnancy within 3 months of death)
IMPORTANT
Major findings : Of operations
Date of
Of autopsy
What test confirmed diagnosis ?
Clesmal Epa
20 Was disease or injury in any way related to occupation of deceased ?
If so, spotify
(Signed )once
. M. D.
(Address) 19602
si
Date F/2
19.60
21
Italy teros
Moce of Burial, Crematinn or Removal.
matain
DATE OF BURIAL ....
may
(City or Town )
3
19 .. 46
22 NAME OF
FUNERAL DIRECTOR Tuddank magnatto
AODRESS
East Botond
Received and fied 6 1940 .19.
( Registrar)
-
Registered No.
81
{ {If death occurred in a hospital or institution. St. [ give its NAME instead of street and numher)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify W'AR)
(a) Residence. No.
(Usual place of abode)
No. PLACE OF DEATH Suffolk (County) instruk (City or Town)) 220 Centlage Park Road michael Reaugh
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.
extracts from the laws on back of certificate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effeot. PARENTS
100m· 1g) - 1- 15-15510
Kofacial Designation)
MEDICAL, CERTIFICATE OF DEATH
4 COLOR OR RACE
(Cive maiden name of wife in hill)
Hacker brace
Physician Underline the cause to which death should be charged s ... listically .
THER
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 furnisbing 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 iu 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 sball, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen bundred 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 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 tomh 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 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, bis 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 cansed by violence, the medi- cal examiner shall make such certificate. If sncb a permit for the removal of a buman 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 sncb removal, unless a permit in the usual form for the removal of such body bas been sooner obtained herennder. If the death certificate contains a recital, as required
by section ten ut chapter sorty-aux, that the deceased served in the army, navy or marine corps of the United States in any war in which it has beca 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 manner or canse of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, 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, S.c. 6.
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 issne snch 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 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 wben 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 deatbs 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 mode of dying. e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related canses, name earlier morbid conditions, if any, related to the principal canse 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, bow- 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
DEPARTMENT OF COMMERCE
BUREAU OF THE CENSUS
STANDARD CERTIFICATE OF DEATH
State File No. Registrar's No.
85
State of 90
1. PLACE OF DEATH:
(a) County
Lolland
2. USUAL RESIDENCE OF DECEASED:
(a) State
mass
Sufalto
(b) City or town
Vernon
(c) City or town
Finthrojs
10
(c) Name of hospital or institution;
Hartford Joke
(d) Street No.
15
Charles
(If rural, give location)
(d) Length of stay; In hospital or institution
In this community
years, months or days)
hra
(c) If foreign born, how long in U. S. A .?
years.
3. (a) FULL NAME Daniel r. B. Calmante
MEDICAL CERTIFICATION
day
25
year
1946
___ minute
pm
21. I hereby certify that I attended the deceased from ...
25
19 46, to
Jan 25
1946.
that I last saw heam alive on
Inever
19
and that death occurred on the date and hour stated above.
Duration
Immediate cause of death Fracture of Skult
Brain Jakeration
8. AGE:
Years 35
Months
Days
If less than one day
hr.
min.
9. Birthplace
(City. town. or county)
10. Usual occupation falls may. + admilead 11. Industry or business Fat. Watt Stores
MOTHER FATHER
12. Name non Gdmanfesten
13. Birthplace
14. Maiden name
15. Birthplace
(City, town. or county)
(State or foreign country)
16. (a) Informant's own signature Surs. W. Edmondaton
(b) Address ... Winthrop mass
17. (a) Evergreen (b) Date thereof 1/09/46
(c) Place; burial or cremation
18. (a) Signature of funeral director
L.G. IF hite
(b) Address Pockerilly CT.
19. (a)
(b)
U. C. Tentocha aux
1/26/46
rocha
(Date received local registrar) (Registrar's signature)
(c)) Where did injury occur?
Vernon
Lolland CF.
(City or town) (County) (State)
(d) Did injury occur in or about home, on farm, in industrial place, in public
place?
Nguy
auto accident
While at work?
(e) Means of injury wed EX-
(Specify type of place)
23. Signature . W. Levine
(M. Dror other).
Il Address
Ellington (+
Date signed 1/25/46
8-6917
U. S. GOVERNMENT PRINTING OFFICE 16-13493
MAY 1 4 1946
PHYSICIAN
Major findings:
Of operations
Of autopsy
Underline the cause to which death should be charged sta- tistically.
22. If death was due to external causes, fill in the following: (a) Accident, suicide, or homicide (specify) accident
(b) Date of occurrence
1-25-46
(Burial, orentation, or removal) Boston Magass
Due to
-
6. (a)Single, widowed, married,
4. Sex
5. Color or
race
divorced
6. (c) Age of husband or wife if
6. (b) Name of husband or wife
Cath
johnson
alive 1 years
1911
7. Birth date of deceased
(Month)
(Day)
(Year)
O.C
Due to
Other conditions.
multiple Fractures
(Include pregnancy within 3 months of death)
county ) Bals (State or foreign country) WC.
4/20. Date of death: Month
3. (b) If veteran, name war
3. (c) Social Security No.
(b) County
(If outside city or town limite, write RURAL)
(If outside city or town limits, write RURAL)
(If not in hospital or institution, write street number or location)
(Specify whether
M R-302
Suffolk
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Boston
(City or town making return)
Registered No.
401086
(If death occurred in a hospital or institution,
SŁ
give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
64 Main
St.
Winthrop Mass.
(a) Residence. No.
(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 day 8.
In this community
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
F
4 COLOR OR RACE|
W
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, widowed, or divoroed
HUSBAND of
(or) WIFE of
( Give maiden name of wife in full)
Frederick.Whitten
(Husband's name in full)
6 Age of husband or wife If allve 4.1.
years
7 IF STILLBORN, enter that faot here.
Years 8 AGE 38 10 Months. 28 .Days
If less than 1 day
Hours .......... Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business:
At Hame
11 Social Security No. None
12 BIRTHPLACE (City)
(State or country)
.Roxbury ...... a.s.s.
13 NAME OF
FATHER
George M Hoyt
PARENTS
15 MAIDEN NAME
OF MOTHER
Eva Smith
New Brunswick Can
17 Informant. (Address)
Husband
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
DATE FILED
May 1
19.46
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
April 25/46
(Month)
(Day)
(Year)
19 1
HERERY CERTIFY,
46
to
April 25
19
April 26,
19 26
death Is said to
have ooourred on the date stated above, at
11;40P
m.
Duration
Immedlate cause of death
Subarachnoid hemorrhage
3 D
Due to.
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
None
Date of.
should be
charged sta- tistically.
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to oooupation of deceased ?.
If so, speolfy
(Signed)
C L Clay
M. D.
(Address)
Mass General Hospt
Date.
4-27 19
46
21 PLACE OF BURIAL,
Woodlawn Cem-Everett Mass.
CREMATION OR REMOVAL.
DATE OF BURIAL
AppCemetery / 46
19
(City or Town)
22 NAME OF
FUNERAL DIRECTOR
L E Parker
ADDRESS
East Boston Mass
Reoelved and filed
MAY 18 1946
19
(Registrar of City or Town where deceased resided)
50m-(b)-6-44.14607
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-802 to the clerk Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased SITITU TINGARING DI ARE INV
PLACE OF DEATH
(County)
1
Boston
(City or Town)
No.
Mass.General Hospital
Viola Whitten
(If U. S.
War Veteran,
speolfy WAR)
Lifers.
That I attended deceased
April 26
19
from 46
I last saw her
allve on
Underline the cause to which death
Of autopsy
Clinical
14 BIRTHPLACE OF
FATHER (City)
(State or country)
New Brunswick Can
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Relation, if any
- THIS IS A DEIMANENT DEPOEN
R-303-A
1
(County) No PLACE OF DEATH Suffolk Fintech (City or Town) Cottage Park yacht Club - Worthing
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or Its Agent.
Registered No.
87
( If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
William I Canthome
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden nanie.)
48 Waldemar An Worthing
(a) Residenoe. No.
(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 community
11/yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR, OR RACE|
(write the word)
5a If married, widowed, or divorceog al Zavet/ tatt HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)' Hart
(Husband's name in full)
6 Age of husband or wife if alive 49 years
7 IF STILLBORN, enter that fact here.
8 49
AGE ... .Years Months. Days
If less than 1 day Hours. Minutes
Usual 9 Occupation :
Industry
10 or Business :
R. me adames
11 Social Security No. 010-05-7496
12 BIRTHPLACE (City)
(State or country )
East Boston, m.
13 NAME OF
FATHER
georgeh Cawthorne
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Eat Boston
(State or country)
15 MAIDEN NAME
OF MOTHER
may@Hello
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Euti Basta
17 Informant
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : 10354
(Signature ADAFent Board of Health or other)
(Official Designafin)Y 6 194 @Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
194%
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY that I have Investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Orman Thintori
20 Accident, suicide, or homicide (specify) Date of occurrence. 19
Where did Injury occur ?
(City or town and State)
Did injury ooour in or about home, on farm, in Industrial place, or In publlo
place ?
(Specify type of place)
Manner of
Injury
Nature of Injury
While at work! Was there an autopsy ?
21 Was disease or Injury in any way related to occupation of deceased ?
If so, speolfy
anmm
M. D.
(Signed)
(Address)
Date 5/4 1946
22 Foly Cross Ven
Malden
Place of Dorial, Cremation or Removal.
(City or Town)
23 NAME OF FUNERAL DIRECTOR ;. Markle Carrell
ADDRESS
Received and filed MAY 25 1946 .19
( Registrar)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
extracts from the laws relative to the return of certificates of death.
50m (g)-1-41-4667
Relation it any DATE OF BURIAL
18 DATE OF
DEATH
May
3
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, 2121 If so specify WAR)
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 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.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one bundred 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 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 bundred and fourteen, the word "war" shall include the China relief ex- pedition 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 Mexi- can border service of nineteen hundred and sixteen and nineteen bundred 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 bave 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- 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 medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the pos- session of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to tbe town from which it was removed within thirty-six hours after such re- moval, unless a permit in the usual form for the removal of such body bas 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
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