USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 52
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MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
august
3
(Month)
(Day) /
(Ycar)
19
I HEREBY CERTIFY,
That I attended deceased from
December 20, 1945, 10 august 3, 1946
I last saw her alive on
august 2, 19 46 death is said to
have occurred on the date stated above. at
4 3ª A.m.
Immediate cause of death
Coronary thrombosis
Duration IMPORTANT 10 minutes
3 years
Due-to-
Chronic Glomerulonephoitis
with
mania
2 months
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
Maurice Traunstein
(Signed)
. M. D.
(Address) 562 Shirley Strin thiop Date
august 319 46
21
Holy Cross com
malcien
Place of Rufial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
aug 5
19 %.
22 NAME OF
Ed: A Jane
FUNERAL DIRECTOR
ADDRESS
201 Bowdoin it worchester
Received and Filed
AUG 7 1946
19
(Registrar)
sce instructions auu extracts from the laws on back of certificate. If deceesed was e U. S. War Veteran, G. L. Chep. 46, Section 10, requires physicians to insert a recital to thet effect.
100m-9-44-14955 1
PLACE OF DEATH
1
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
Wincheap
St.
(If nonresident, give city or town and State)
1946
Due to
asteriosclerotic Heart
Disease
Other conditions
none
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy
RE
What test confirmed diagnosis?
Clinical + Laboratory
PARENTS
12 BIRTHPLACE (City)
(State or Country)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital 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, bis supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of bis last illness, wben last seen alive by the physician or officer and the date of bis death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnisbing a certificate of death as required by tbe preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of bis knowledge and belief, served in the army, navy or marine corps of the United States in any war in wbicb 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 be can state the same. For neglect to comply with any provision of this section, sucb 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 bave taken place between February fourteenth, eighteen bundred and ninety-eight and July fourtb, nineteen hundred and two, and the Mexican border service of nineteen bundred and sixteen and nine- teen bundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person sball bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he bas received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the sanie 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 sball 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 pbysi- cian who is a member of the board of bealth, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If deatb 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 vi chapter fully-six, tual 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 manner 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 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.
No undertaker or other person sball bury a human body or the asbes 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 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. . . . Cbap. 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 sucb deatbs only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to sucb deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died 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 causcd 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 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, astbenia, etc. As principal cause name the disease causing deatb. As related causes, name carlier 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
2-301 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
Winthrop Community Hospital
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.
141.
f (If death occurred in a hospital or institution, { St. { give its NAME instead of street and number) /
2 FULL NAME
Cora Battefeld
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
29 Ingleside Ave., Winthrop
St.
(Usual place of abode)
(If nonresident, give city or town and State)
In this community
35
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
5a It married, widowed or divorced
HUSBAND ot ..
(Give maiden name of wife in full)
(or) WIFE of
John Battefeld
(Husband's name in full)
6 Age of husband or wite if alive years
7 IF STILLBORN, enter that fact here.
8
AGE 80
Years
7
Months
13
Days
If less than 1 day
.. Hours
Minutes
Usual
9 Occupation:
Housew.fe
Industry
10 or Business:
At Home
11 Social Security No.
Washington
12 BIRTHPLACE (City).
(State or Country)
Maine
13 NAME OF FATHER Alfred Rockwell
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Maine
15 MAIDEN NAME
OF MOTHER
Frances Rockwell
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Nova Scotia
17 Charles L Sherman
Informant (Address! 4 Montrey St. Worcester, Mass. I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial por transit permit was issued: Viralter & Bakes (Signature of Agfof of Board ofHealth or other) Health Oficer 8/9/46
(Official Designation) (Date of Issue of Permit)
19 I HEREBY CERTIFY,
That I attended deceased from
august
3
, 1946, to august ?
, 19 46
I last saw h&+ alive on
august 7.
7 19 46, death is said to
have occurred on the date stated above. at
5 25 P. m.
Duration
Immediate cause ot death
Comercio
Chronic glomerulonephoitis with
cemia
IMPORTANT
Due to
arterioscleratic Heart
disease
Due to
shoves state 2 we
Other conditions Chronic Chole cystitis and chalelithiasis (Include pregnancy within 3 months of death) chileithe !.
Major findings:
Of operations
home
Date ot
Of autopsy
-
What test confirmed diagnosis? Clinical + Laboratory
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically. no
20 Was disease or injury in any way related to occupation of deceased?
It so, specify
(Signed) Maurice Traunstein
M. D.
s) 562 Shirley St. Winthis Date Onrequest 7 1946
21
Winthrop
Place of Burial, Cremation or Removal.
Aug. 10, 1946
DATE OF BURIAL
Winthrop (City or Town) 19
22 NAME OF
Richard 16 White
FUNERAL DIRECTOR
ADDRESS
147 Winthrop St., Winthrop
Received and Filed
AUG 9
1946
19
(Registrar)
See instructions and extracts from the laws on back of certincate. If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. fokeng. per m. While
100m-9-44-14955
MEDICAL CERTIFICATE OF DEATH
1946
(Month)
(Year)
18 DATE OF DEATH august 7 (Das)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
2
days.
5 days 2 years
PARENTS
Relation, if any
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 bis 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 helief 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 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 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 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 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 uo 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 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, 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 hy it or hy 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 auch 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 body has been sooner obtained hereunder. If the death certificate contains a recital, as required
by section ten vi chapter 101 ty-six, qual ne 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 manner 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 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 hody is to he 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 by recognized disease unrelated to any forum 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 deathis caused directly or indirectly by traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following 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 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
R-305
1
No. PLACE OF DEATH - S SUFFOLK BenytofTown)
60 CONGRESS ST
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No.
708312
(If death occurred in a hospital or institution, St.
give its NAME instead of street and number)
HALSEY W KELLEY
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
War Veteran,
speolfy WAR)
-
(a) Residsnoo.
No.
(Usual place of abode)
5| BIRCH RD
St.
WINTHROP
(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
yro.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
MALE
4 COLOR OR RACE
WHITE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED WIDOWED
5a If married, widowed, or divorced HUSBAND of
MYRA JOHNSON
(or) WIFE of
(Husband's name in full)
6 Ags of husband or wife If allvs years
7 IF STILLBORN, enter that faot hers.
8
AGE
78
Years
Months.
Days
If less than 1 day
Hours .........
.Minutss
Usual
9 Oocupatlon :
S.A.LEGMAN
Industry
10 or Business :
11 Soolal Security No.
A L A AUTOMOBILE INS CO
12 BIRTHPLACE (City)
(State or country )
NEW HAVEN CI.
13 NAME OF
FATHER
FREDERICK H KELLEY
PARENTS
14 BIRTHPLACE OF
FATHER (City)
GOSHEN CONN"
(State or country)
15 MAIDEN NAME
OF MOTHER
MARY THOMPSON
16 BIRTHPLACE OF
MOTHER (City)
NE.W ... HA.VEN ... CONN.
(State or country)
17
Informant
(Address)
SON
Relation, if any
A TRUE COPY.
ATTEST:
(Registrar of city or ABB whey /drgth occurred)
DATE FILED 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
A.uQ.u.s.T ..... 7/46
(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.) COMPOUND FRAC OF SKULL WITH LACERATION OF BRAIN
20 Aooldent, sulolds, or homlolde (specify)
ACCIDENT
Date of ooourrenoe
8/9.46
Where did
Injury occur ?
BOSTON
(City or town and State)
Did Injury ooour In or about the home, on farm, In Industrial place, or In
publlo place?
OFFICE BUILDING
(Specify type of place)
Manner of
CRUSHED IN ELEVATOR HEAD INJURY
InJury
Nature of Injury
While at work ?
Was there an autopsy ?.
..........
NO.
21 Was dissase or Injury In any way related to oooupation of dsoeased?
If so, speolfy
(Signsd)
A " MORITZ
M. D.
(Address)
BOSTON
Dats.
8/9/46
22
FRANKLIN CEM
FRANKLIN CONN
Place of Burial, Cremation or Removal.
DATE OF BURIAL
AUG 12/46
19
(City or Town)
23 NAME OF
FUNERAL DIRECTOR
A A MARSH
ADDRESS
W.4.N.T.H.R.O.P ... 44A.8 8
Reosived and filled.
"AUG-19-1946
19
(Registrar of City or Town where deceased resided)
25m-(d)-6-43-12056
Of the city or town in which the deceased resided as soon as possible after the close of the month in which the desta occurred. (See Chap. 46, Sec. 12, Q. L.)
(Give maiden name of wife in full)
19
1
A
PLACE OF DEATH
Suffolk (County)
Winthrop. (City or Town)
No. 44 Prospect Avenue
The Commonfocalth 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.
Registared No. 1.43. ....
§ (If death occurred in a hospital or institution, St [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME.
Wilhelmine (Lauritzen) Anderson.
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
44 Prospect Avenue
St.
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
(Specify whether)
years
months
days.
(If nonresident, give city or town and State)
in this community 15 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
female
4 COLOR OR RACE
white
5 SINGLE
( write the word)
MARRIED
widowed
WIDOWED
or OIVDRCEO
5a If married, widowed, or divorced HUSBANO of
(or) WIFE of
( Husband's name in full)
yaars
7 IF STILLBORN, enter That fact here.
8
AGE 6.3 .... Years
4 Months 13 Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
At ..... Home
Industry 10 or Business:
11 Social Security No.
none.
viborg
12 BIRTHPLACE (City)
( State or country)
Denmark.
PARENTS
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