USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1946 > Part 88
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(Signature of Agent of Board of Health or other)
Health / (Official Designation)
officer
(Date of Issue of Perme) 147
Immediate cause of death Cerebral hemorrhage
Due to Hypertension
Due to
Other conditions
Chronic myocarditis
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Date of
Of autopsy
none
What test confirmed diagnosis?
Duration IMPORTANT 2 hrs. years
years 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? NO.
If so, specify
d) almanar
. M. D.
(Signed)
(Address) Monthvos Mis
Date /alex
1946
21
Winthrop
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
January
2
19
47
Howard & hyroled 0
ADDRESS
22 NAME OF
FUNERAL DIRECTOR
Winthing
mars.
Received and Filed JAN 3 1947
19
(Registrar)
00m-9-44-14955
(per Mr. Reynolds If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital to that effegt. PARENTS
(a) Residence. No. 329 Winthrop (Usual place of abode)
Length of stay: In hospital or institution hr. 5 mins .years
(Before death)
(Specify whether)
months
days.
In this community
yrs.
2
5a If married, widowed or divorced HUSBAND of (or) WIFE of
(Give maiden name of wife in full)
(Husband's name in full)
MEDICAL CERTIFICATE OF DEATH
St.
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 e death of a person whom he has attended during his last illness, at the quest of an undertaker or other authorized person or of any member of family of the deceased, furnish for registration a standard certificate death, stating to the best of his knowledge and helief the name of the ceased, his supposed age, the disease of which he died, defined as re. ired by section one, where same was contracted, the duration of his last ness, when last seen alive by the physician or other and the date of death ... Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the eceding section or by section forty-five of chapter one hundred and four- en, shall, if the deceased, to the best of his knowledge and helief, served the army, navy or marine corps of the United States in any war in which has been engaged, insert in the certificate a recital to that effect, speci- ing the war, and shall also certify in such certificate both the primary d the secondary or immediate cause of death as nearly as he can state e same. For neglect to comply with any provision of this section, such ysician or officer shall forfeit ten dollars. For the purposes of this sec- on and of sections forty-five, forty-six and forty-seven of said chapter e hundred and fourteen, the word "war" shall include the China relief pedition and the Philippine insurrection, which shall, for said purposes, deemed to have taken place between February fourteenth, eighteen indred and ninety-eight and July fourth, nineteen hundred and two, and e Mexican horder service of nineteen hundred and sixteen and nine. en hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall hury or otherwise dispose of a human dy in a town, or remove therefrom a human body which has not been ried, until he has received a permit from the board of health, or its ent appointed to issue such permits, or if there is no such board, from e clerk of the town where the person died; and no undertaker or other rson shall exhume a human body and remove it from a town, from one metery to another, or from one grave or tomb other than the receiving mb to another in the same cemetery, until he has received a permit from e board of health or its agent aforesaid or from the clerk of the town here the body is buried. No such permit shall be issued until there shall ve been delivered to such board, agent or clerk, as the case may he, satisfactory written statement containing the facts required by law to he turned and recorded, which shall be accompanied, in case of an original terment, by a satisfactory certificate of the attending physician, if any, required by law, or in lieu thereof a certificate as hereinafter provided. there is no attending physician, or if, for sufficient reasons, his certificate nnot be obtained early enough for the purpose, or is insufficient, a physi- an who is a member of the board of health, or employed by it or hy the lectmen for the purpose, shall upon application make the certificate re- tired of the attending physician. If death is caused by violence, the medi. l examiner shall make such certificate. If such a permit for the removal a human body, not previously interred, from one town to another within e commonwealth cannot be obtained early enough for the purpose, the rtificate of death made as above provided and in the possession of the dertaker desiring to make such removal shall constitute a permit for ich removal; provided, that such body shall be returned to the town from hich it was removed within thirty-six hours after such removal, unless permit in the usual form for the removal of such hody has been sooner tained hereunder. If the death certificate contains a recital, as required
by section ten of chapter toity-six, tuat the ucceaned 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 hoard, 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 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 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 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
T
PLACE QF DEATH
1 Suffolk TY (County) Winthrop (City or Than)
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.
249
If . ah occurred in a hospital of instituti .. its NAME instead f street and number) f
20
PHYSICIAN - IMPORTANT
( Was deceased a
U. S. War Veteran,
if so specify WAR
St.
(If nonresident, give city or town and State
mos.
3
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4
COLOR OR RACE
White
5 SINGLE
(write the wo
single
WIDOWED
OL DIVORCED
5a If married, widowed or divorced HUSBAND of .
(or) WIFE of
(Give maiden name of wife in full)
(Husband's name in fu !!
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE
Years
Months
Days
3
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
none
Industry
10 or Business:
none
11 Social Security No .. . .
none
12 BIRTHPLACE (City)
(State or Country)
Ninchiop. mass
13 NAME OF
FATHER
Herbert Gordon
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Basta
mass
15 MAIDEN NAME
OF MOTHER
Rose Brown
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Lynn
moms
17 Hubert Gordon ( rather Relation, if any ) (Address: 68 Park and Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Hatte
(Signature of Agent y Board of Health or other)
Health (Official Designation) (Date of Issue of Peyfar
affecte
17/30/46
I HEREBY CERTIFY. That I attended deceased from
Sec.
28
, 1946, to Dec 30
19
46
! last saw h
er
chve on
Dec. 29. 1946 death is said to
have occurred on the date stated above. at 7:30 A. m. Duration
IMPORTANT
Immegate cause of death
Prematurity - 6 mo.
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
1
Underline the cause to which death should be
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased?
it so, specify
city
(Signed) 20 Dilemma
. M. D.
(Address 34 Cal
Are Date 121.
×6
DATE OF BURIAL
Alec
3/
19
22 NAME OF
FUNERAL DIRECTOR
H. J. org
ADDRESS /S/ Washington was chekca
Received and Filed JAN 3 1947
19
( Registrar)
.
a) Residence. No. (Usual place of abode)
Length of stay: In hospital or institution Nosp.
( Before death
Specify whether
years
months
3
days.
In this community
yrs.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Dec.
(Month
30,
Day
1946
( Ycar)
40 hours
IMPORTANT
Physician
Of autopsy
chadsta-
III .cally.
100m-9-44-14955
. Winthrop Comm Hospital st. 3
2 FULL NAME Baby Girl
GORDON
( If deceased : a married, widowed or divorced woman, give also maiden name.
68 Park ave
if deceesed was e U. S. Wer Veteren, G. L. Chap. 46, Section 10, requires physicians to insert e recitel to thet effect. PARENTS
301 A
21 Bulgaradel Cem,
Place of Burial, Cremation or Removal.
City of Town
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 death of a person whom he has attended during his last illness, at the quest of an undertaker or other authorized person or of any member of family of the deceased, furnish for registration a standard certificate death, stating to the best of his knowledge and helief the name of the ceased, his supposed age, the disease of which he died, defined as re- ired by section one, where same was contracted, the duration of his last ness, when last seen alive by the physician or othicer and the date of death . .. Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the ceding section or by section forty five of chapter one hundred and four- en, shall, if the deceased, to the best of his knowledge and helief, served the army, navy or marine corps of the United States in any war in which has been engaged, insert in the certificate a recital to that effect, speci- ing the war, and shall also certify in such certificate both the primary d the secondary or immediate cause of death as nearly as he can state same. For neglect to comply with any provision of this section, such ysician or officer shall forfeit ten dollars. For the purposes of this sec- n and of sections forty-five, forty-six and forty-seven of said chapter e hundred and fourteen, the word "war" shall include the China relief pedition and the Philippine insurrection, which shall, for said purposes, deemed to have taken place between February fourteenth, eighteen ndred and ninety-eight and July fourth, nineteen hundred and two, and Mexican border service of nineteen hundred and sixteen and nine- en hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human dy in a town, or remove therefrom a human body which has not been ried, until he has received a permit from the board of health, or ita ent appointed to issue such permits, or if there is no such board, from e clerk of the town where the person died; and no undertaker or other rson shall exhume a human body and remove it from a town, from one metery to another, or from one grave or tomb other than the receiving nb to another in the same cemetery, until he has received a permit from e board of health or its agent aforesaid or from the clerk of the town here the body is buried. No such permit shall be issued until there shall ve been delivered to such board, agent or clerk, as the case may he, satisfactory written statement containing the facts required by law to be turned and recorded, which shall be accompanied, in case of an original terment, by a satisfactory certificate of the attending physician, if any, required by law, or in lieu thereof a certificate as hereinafter provided. there is no attending physician, or if, for sufficient reasons, his certificate nnot be obtained early enough for the purpose, or is insufficient, a physi- an who is a member of the board of health, or employed by it or by the lectmen for the purpose, shall upon application make the certificate re- ired of the attending physician. If death is caused by violence, the medi- 1 examiner shall make such certificate. If such a permit for the removal a human body, not previously interred, from one town to another within e commonwealth cannot be obtained early enough for the purpose, the rtificate of death made as above provided and in the possession of the dertaker desiring to make such removal shall constitute a permit for ch removal; provided, that such body shall he returned to the town from hich it was removed within thirty-six bours after such removal, unless permit in the usual form for the removal of such body has been sooner tained hereunder. If the death certificate contains a recital, as required
by section teu vi chapter ionly . six, Ludi the ueceased 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 ohtained 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 hody 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 hoard, from the clerk of the town where the body is to he huried or the funeral is to he 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 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 deaths 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, 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 morhid 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
1 A
1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No. 36 Atlantic St
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.
250
st& (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Mary Wheeler (Magee) Hall
( If deceesed is a married, widowed or divorced woman, give also maiden name.)
(a) Residenca. No.
36 Atlantic St
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In Anepital or Institution
( Before death)
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED Widowed
female
white
5a If married, widowed, or divoroed
HUSBAND of
( Give maiden name of wife in full)
(or) WIFE of
Isaac .... Charles .... Hail
( Husband's name In full)
6 Age of husband or wife if eliva yaars
7 IF STILLBORN, enter that fact here.
8
92
10
22
If less than 1 day
Hours
Minutes
Usual
9 Occupetion :
At home
Industry
10 or Business :
11 Social Security No.
none.
Winthrop
12 BIRTHPLACE (City)
( State or country)
Mas'S
13 NAME OF
FATHER
Edward Magee
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Mass
15 MAIDEN NAME
OF MOTHER
Carolyn Sturgis Tewksbury
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
unable to obtain
17
Informent
Mrs Frank P ... Magee (
36 Atlantic St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificata of deeth was filled with me BEFORE the burial or transit permit was Issued ? Walter A Makeel
(Signature of Agent of Board of Health or other) 1/3/47
(Oficial Designation) ( Date of Issue of Permit
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December
30
1946
( Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
Thet I attended deosased from
7el.
1
1942
Ło ..
194/6
I last sawh Ch alive on
30, 1946, death is said to
have occurred on tha date stated above, at.
9%'
m.
Duration
Immediate oause of death.
IMPORTANT .. ..........
4 /2.
Due to
Due to
Other conditions.
( include pregnancy within 8 months of death)
Mejor findings:
Of operetions
Date of
Of autopsy
What test confirmed diegnosis?
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in eny way related to occupation of deoeesed ?
If so, spaoify ..
( Signed).
(Address) 13 fi -02-0-151
. M. D.
Oate ..
19.44 1
21
Winthrop Cemetery, Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL ... Jan .... 2, 1947
19
22 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
174 Winthrop St, Winthrop
Recalved and fled JAN 3 1047
19
( Reddet rar }
100m-(g)-1.45-15510
PARENTS
AGE
Yeers
Months
Oays
years
months
days.
In this community
yre. Io mos.
dayı.
93
PHYSICIAN - IMPORTANT
(Was deceased 2
U. S. War Veteran,
if so specify WAR). N.O.
Relitiorete any
Boston
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 persou 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 hest 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 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 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 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 bury or otherwise dispose of a human body in a town, or remove therefrom a human hody which has not heen buried, until he has received a permit 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 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 hody is huried. 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 he 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 nc attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the hoard of health, or employed 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 be obtained early enough for the purpose, the certificate of death made as ahove 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
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