Town of Winthrop : Record of Deaths 1946, Part 50

Author: Winthrop (Mass.)
Publication date: 1946
Publisher:
Number of Pages: 526


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 50


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PNEUMONial


Other conditions.


(luclude pregnancy within 3 months of death)


Major findings : Of operations.


Date of.


Of autopsy


What test confirmed diagnosis?


IMPORTANT Physician t'underline the cause to which death shouht be charged sta- tistically.


20 Was disease or injury in any way related to ocoupation of deceased ?.


If so, specify.


...


(Signed)


(Address)


Trhy 20 Date 7/20


winthrop


M. D. 1946


21


winthrop


l'lace of Burial, Cremation or Removal. (City or Town)


DATE OF BURIAL.


July 25, 1946


19


22 NAME OF FUNERAL DIRECTOR Richard 16 HChute


ADDRESS


147 Winthrop St . Winthrop


Received and filed JUL 24 1946


19


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


00m (d)-1-41-4667


ErnestPepper


Relation, if any


PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)


St.


(If nonresident, give city or town and State)


death Is said to


Immediate oause of death.


(Give maiden name of wife in full)


Female White


No. 9 ... Wilshire .... St ......... Winthrop


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 iluring his last illness, at the request of an umlertaker or other authorized person or of any member of the faniily 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 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 hy the preceiling section or by section forty- five of chapter one hundred and four- teen, shall, if the deceased. to the best of his knowluilge and belief, served in the army, navy or marine corps of the I'nited States in any war in which it has been engagent, insert in the certificate a recital to that effect, spr-ci- 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 ilollars. 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 wonl "war" shall include the China relief ex- pedition 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 Mexi- can border service of nineteen humlred 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 boily 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 huried. No such permit shall be issued until there shall have been delivered to such board, ageut or clerk, as the case may be, a satisfactory written statement containing the facts required by law to he returned aml 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 attenling physician. If death is caused hy violence, the niedi- 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 carly enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, 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 l'nited States in any war in which it has hren engaged. such recital shall appear upon the permit. The board of health, or its agent. ujem receipt of such statement atut certificate, shall forthwith counter-ign it all transmit it to the clerk of the town for registration. The person to whom the perinit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other nece+ sary information which can be obtained as to the deceased, or as to the manter or canse of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45. G. L., (Tercentenary Edition).


No uialertaker or other person shall bury a human hody or the ashes thereof which have been hrought into the commonwealth until he has re- ceived a permit so to do from the hoard 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 amminteil 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 boily 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 boilside 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 atteinlance or whose physi- cian 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 inchile not only deaths caused directly of in- directly by traumatism (including resulting septicemia), and by the action of clinical ( drugs or poisons). thermal, or electrical agrids, 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 moile of dying. e. g .. heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, natne 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 discase causing death, report the usual occupation prior to illness. If the ileceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed inay be returned as at school or at home. For a woman whose ouly occupation was that of home housework, 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


R-302


1


PLACE OF DEATH


SUFFOLK BOSTON


...


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


BOSTON (City or town making return) 135


Registered No.


6656


(If death occurred in a hospital or institution,


give its NAME instead of street and number)


2 FULL NAME


Mary Lina Woods


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence. No.


23 Atlantic Ave


St.


Winthrop


.Mass ..


(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


10 days.


In this community 60 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


F


4 COLOR OR RACE|


W


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED


Wid


5a If married, widowed, or divoroed


HUSBAND of


1


19 | HEREBY CERTIFY,


That I attended deceased from


19


to


19


I last saw h.


allve on.


19


death Is sald to


have ooourred on the date stated above, at


m.


Duration


Immediate cause of death Toxic cirrhosis of liver


Ter


Pulmonary ..... doma


dys


8 AGE ... 68 Years 1 Months .. 1.7. .Days


If less than 1 day Hours Minutes Due to.


Usual


9 Occupation :


At Home


Industry 10 or Business :


11 Soolal Security No .... None


12 BIRTHPLACE (City)


(State or country)


Boston, Mass.


Other conditions.


(Include pregnancy within 3 months of death)


Physician


Major findings :


Of operations


Date of


should be


charged sta- tistically.


Of autopsy What test confirmed diagnosis?


20 Was disease or injury in any way related to occupation of deceased?


if so, speolfy.


(Signed)


W R Dudon


M. D.


(Address)


Boston


Date


7/25 29


46


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


Winthrop Cometory, Win,


DATE OF BURIAL


July 29/48


(Cemetery


(City or Townthro


19


22 NAME OF


FUNERAL DIRECTOR


A B Marsh


ADDRESS


Winthrop Mass.


Jul 20/16- 19


Received and filed.d&G ··· 7 ······- 1946


( Rowietrar of City or Town


where derpased reside


!


of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)


50m- (b).6-44-14607


17 Ardelle Woods


Relation, if any


Informant ..


(Address)


Daughter


A TRUE COPY, DYchuel & Morning


ATTEST:


(Registrar of city or town where death occurred)


DATE FILED


9/30/46


19


18 DATE OF


DEATH


July 25/46


(Month)


(Day)


(Year)


(Give maiden name of wife in full)


(or) WIFE of


Phares Lurton Ho&


(Husband's name in full)


6 Age of husband or wife If allve


years


7 IF STILLBORN, enter that faot here.


PARENTS


13 NAME OF


FATHER


James McDougall


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Scotland


15 MAIDEN NAME


OF MOTHER


Lucetta Celia Phillips


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


New York


Due to.


Underline the cause to


which death


(City or Town)


No.


Peter Bent Brigham Hospital


St.


(If U. S.


War Veteran,


speolfy WAR)


H


R-301 A


1


PLACE OF DEATH


Suffolk (County)


Winthrop (City or Town) 65 Brewster Ave.,


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.


136


St. (If death occurred in a hospital or institution, ! give its NAME instead of street and number) )


2 FULL NAME


Susan G.Wood, (Peirce)


(If deceased is a married. widowed or divorced woman, give also maiden name.)


PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR) No


(a) Residence.


No.


28 Gilmore St.,


Everett


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


2 months


days.


In this community


73


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


Female


4 COLOR OR RACE


White


5 SINGLE (write the word)


MARRIED


WIDOWED


or DIVORCED


Widow


5a If married, widowed or divorced


HUSBAND of


Giro paigenHameg de 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.


8


73


AGE


Years


3


Months


Days


21


If less than 1 day


Hours


Minutes


Usual


9 Occupation:


Housework


Industry


10 or Business:


Own Home


11 Social Security No ..


None


Everett


12 BIRTHPLACE (City)


(State or Country)


Massachusetts


13 NAME OF


FATHER


George W.Pierce


14 BIRTHPLACE OF


Everett


FATHER (City)


(State or Country)


Massachusetts


15 MAIDEN NAME


OF MOTHER


Esther Wiley


16 BIRTHPLACE OF


MOTHER (City)


(State or Country)


New Hampshire


17


Miss Helen G.Wood


(


Beluigh ter )


Informant


(Address)


28 Gilmore St., Everett, Mass.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transt? permit was issued: Walter A. Saker (Signature of Agent of Boary of health or other)


Health


(Official Designation)


officer


(Date of Issue of Permit) 7/29/46


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


)


(Month)


22


(Day)


4.6 Ycar)


19


I HEREBY CERTIFY,


That I attended deceased from


7/1/44


19


,


I last saw her alive on


7/20


have occurred on the date stated above, at


, death is said to


/ 46 19 ga, m. Immediate cause of death Ingocarditis


Duration


IMPORTANT 2 yrs


500


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


(Signed) James 7 Brus


(Address)


Everett.


, M. D.


Date 7/27


12/6


Woodlawn-sverett, Massachusetts 21


Place of Burial, Cremation or Removal.


(City or Town)


DATE OF BURIAL


Juży 29, 1986


19


22 NAME OF


FUNERAL DIRECTOR


J. E.Henderson Company


ADDRESS


517 Broadway Everett, Mass.


Received and Filed


JUL 3 1 1946


19


(Registrar)


Y


Due to


Due to


Other conditions (Include pregnancy within 3 months of death)


Major findings:


Of operations


no


Date of


Of autopsy 200


What test confirmed diagnosis?


Clinical Signs


Conway


100m-9-44-14955


No.


. See instructions and 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 effect. PARENTS


Peirce


, to


7/27/46, 19


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 hy section one, where same was contracted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.


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 army, navy or inarine 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 fourteen, 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 hody in a town, or remove therefrom a human hody 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 hoard, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human hody 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 hoard, 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 hody, not previously interred, from one town to another within the commonwealth cannot he 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 hody shall he returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such hody has been sooner obtained hereunder. If the death certificate contains a recital, as required


by section ten of chapter toriy-six, toat 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 nianner or cause 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 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 body lies and take charge of the same; ... - General Laws, Chap. 38, Sec. 6.


No undertaker or other person shall hury a human hody 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 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).


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 deaths 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 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, 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 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 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, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


C


R-302


of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)


25M-(f)-11-42 10746


PLACE OF DEATH


Middlesex (County)


Everett (C'ity or Town)


No. Whidden Hospital


The Commonfocalth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


EVERETT


(City or town making return)


(If death occurred in a hospital or institution, St.


giv give its NAME instead of street and number)


2 FULL NAME


Baby Shuman


(If deceased is a married, widowed or divorced woman, give also maiden name.)


17


Hutchinson


St.


(If nonresident, give city or town and State)


Length of stay: In hospital or Institution .... ho.s.p.i.t.al


(Before death)


(Specify whether)


years


months


days.


In this community


yrs.


mos.


daye.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


m


4 COLOR OR RACE


white


5 SINGLE


(write the word)


single


(Month)


(Day)


(Year)


19


ITHEREBY CERTIFY,


That i attended deceased from


19.


.4.6


to


19 .. 46 ..


I last saw h


allve on


19.4.6, death Is said to


have occurred on the date stated above, at


m.


Duration


Inimedlate cause of death


Stillborn


Due to.


Due to.


Other conditions


(Include pregnancy within 3 months of death)


Physician


Major findings :


Of operations


Date of


Underline the cause to which death should be charged sta- tistically.


What test confirmed diagnosis ?


20 Was disease or injury in any way related to occupation of deceased ?


If so, specify.


(Signed)


J. C. Henken


M. D.


(Address)


Everett


Date ..


7-5 19 46


Beth Israel, Everett


21 PLACE OF BURIAL,


CREMATION OR REMOVAL


(Cemetery)


((gity or Town)


19


DATE OF BURIAL


22 NAME OF


FUNERAL DIRECTOR


ADDRESS


HI. J. Torf


Chelsea


A TRUE COPY.


ATTEST :


(Registrar of city or town where death occurred) 7-9- .19 46


Received and filed


AUG 1 2 1946


.19 46


DATE FILED


18 DATE OF


DEATH


July


5,


1.946


MARRIED


WIDOWED


or DIVORCED


5a 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




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