USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 36
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Length of stay: In hospital or Institution.
(Before death)
(Specify whether)
years
months days.
In this community 18 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX M
4 COLOR OR RACEÍ
W
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
5a If married, widowed, or divorced Cecelia V Doyle HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in fuli)
6 Age of husband or wife if alive
49
years
7 IF STILLBORN, enter that fact here.
8 AGE .. .56 Years 5 Months. Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Statistician
Industry
10 or Business :
O.P.A.
11 Soolal Seourity No.
025-14-9205
12 BIRTHPLACE (City)
(State or country )
Cambridge Mass.
13 NAME OF
FATHER
Frederic Shackley
14 BIRTHPLACE OF
FATHER (City)
Cambridge Mass.
(State or country)
15 MAIDEN NAME
OF MOTHER
Cecelia Doyle
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Cambridge Mass.
17 Informant (Address)
Wife
A TRUE
ATTEST !
Michael Filanning
(Registrar of city or town where death occurred)
DATE FILED
May ... 23
19
47
MEDICAL CERTIFICATE OF DEATH
May 18/47
(Day)
(Year)
19 | HEREBY CERTIFY that I have investigated the death of the person above-named end thet the CAUSE AND MANNER thereof are es follows: (If an injury was involved, state fully.) General Peritonitis
Acute Cholecystitis
Atrophic Cirrhosis of Liver
20 Accident, sulolde, or homloide (specify)
Date of ocourrenoe
19
Where did Injury occur ? (City or town and State)
Did Injury ooour in or about the home, on farm, in Industrial place, or In publio place? (Specify type of place)
Manner of
InJury
Collapsed at home and died soon
Nature of
after entrance to hospital
Injury
While et work?
Was there an autopsy?
Yos
21 Was disease or Injury In eny way related to oooupation of deceased ?
If so, specify.
(Signed)
W J Brickley
M. D.
(Address)
Boston Mass
Date 5 .... 1.9 ....
.19
47
22 Orleans ... Cem-Orleans .. Mass.
Piace of Burial, Cremation or Removal.
(City or Town)
Reiation, if any
DATE OF BURIAL
May .... 22/47
19
23 NAME OF
FUNERAL DIRECTOR
R.H. White
ADDRESS
Winthrop Mass ..
Reoelved and filled.
MAY 2-9-1947
19
(Registrar of City or Town where deceased resided)
1
PARENTS
25m. (d) .6-43-12056
18 DATE OF
DEATH
(Month)
(If U. S.
War Veteran,
speolfy WAR)
Mass.
W W #1
Enl. April 28,1918 Discharged April 21,1919
Pvt. Medical Detach. Serial No. 2720307
+
M R-301 A
1
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) Winthrop Community Hospital No. .
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.
105
(If death occurred in
St. 3
a hospital or institution, !
give its NAME instead of street and number) }
PHYSICIAN - IMPORTANT
2 FULL NAME un se, w. (If deceased is a marriedy widowed or divorced woman, give also maiden name.)
800 Loring. Rd.
St.
(If nonresident, give city or town and State)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
years
months
1
days.
In this community 29 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
Male
White
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED Married
5a If married, widowAd theworkillilea
HUSBAND of
(Give maiden name of wife in full)
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
8 AGE 64 Years Months Days
If less than 1 day
Hours
Minutes
Merchant
Plumbing
11 Social Security NO. 23 -- 09 -- 7945
12 BIRTHPLACE (City). .
Boston
(State or Country) Mass
13 NAME OF
FATHER
John Burke
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Ireland
15 MAIDEN NAME
OF MOTHER
Catherine Calnan
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Ireland
17
Anna B rke
( Aqapg. if any )
86 Loring Rd
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or Transit permit was issued:
(Signature of Apeut h,f Ward of Hea'sh or other)
Office, 5/ 20 147 (Date of Issue of Permit)
18 DATE OF DEATH may
(Month)
(Day)
1947 (Ycar)
19 I HEREBY CERTIFY, That I attended deceased from
7cm 5/19.19 47 . to
, 19
I last saw halive on
have occurred on the date stated above, at
/19 8/20 19 9 7
death is said to
Duration
Immediate cause of death Rasjon
Due to
Card
paralyin. montage .
IMPORTANT 1/2 hus
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) Edward I (Address) 148 Wind
+ 98 5 14
, M. D. 19 47
21
Holy
Cross
Malden
(City or Town)
Place of Burial, Cremation of Removal. DATE OF BURIAL May 1947 19
22 NAME OF FUNERAL DIRECTOR
Femaley
ADDRESS
Winthrop
Received and Filed MAY 21 1947
19
(Registrar)
100m-0-44-14955
3 SEX (or) WIFE of Usual 9 Occupation: PARENTS Informant (Address· If deceased was . U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recitai to that effect. See instructions and extracts from the laws on back of certificate. DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF Industry 10 or Business:
4
COLOR OR RACE
(Husband's name in full)
61
years
Due to
Other conditions (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
·
MEDICAL CERTIFICATE OF DEATH
L
{ Was PREUVE U. S. War Veteran, if so specify WAR)
(a) Residence. No.
(Usual place of abode)
Maler istalti (Official Designation)
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 by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the 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 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 have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall 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 teu of chapter forty-six, tuat inc 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 shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be 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 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 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, 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 heen given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation by the appropriate terms, as housekeeper- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
M R-302
3 SEX
Female
8
63
AGE.
PARENTS
Informant.
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
Copies of returns of deaths recorded during the previous month which occurred in your etty or towi in case the deceased
industry
10 or Business :
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-808 to the clerk
50m . (b) -6-44-14607
A TRUE COPY.
ATTEST:
(Registrar of city or town where death occurred)
May
23
19
47
18 DATE OF
5 SINGLE
(write the word)
DEATH
May
19
1947
(Month)
(Day)
(Year)
19.I HEREBY CERTIFY, That I attended deceased , from
Mar.
1,
1946
to
Max
19.
19.47
I last saw her
.. alive on ..
May
16
1947
death is said to
have occurred on the date stated above, at
6:00A
m
Duration
immedlate cause of death
Gen, Carcinomotosis
1 ..... Yr.
Due to
Adenocarcinoma, Grade II
o.f ..... the ..... descending ..... Colon
3 Yrs.
Due to.
Other conditions
None
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Underline the cause to which death should be cherged sta- tietically.
Of autopsy
What test confirmed diagnosis ?
20 Wss disease or injury In any way related to oooupation of deceased ?
No
if so, speolfy.
Myron N ...... King
(Signed)
M. D.
(Address)
562 Shirley St ... Date.
5/199 47
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ..
Winthrop
(Cemetery )
Winthrop
(City or Town)
19.
47
DATE OF BURIAL
May
21.,
22 NAME OF
Howard S. ... Reynolds
FUNERAL DIRECTOR
ADDRESS
Winthrop,
Mass.
Received and filed
(Registrarfor City or Town where deceased residedit) ...
19
DATE FILED
PLACE OF DEATH
Suffolk
(County)
Revere
(City or Town)
214 Endicott Avenue
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Revere
(City or town making return)
Registered No.
106
(If death occurred in a hospital or institution,
St.
give its NAME instead of street and number)
2 FULL NAME.
Elizabeth Muir
(Givan)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
430 Rovere
SŁ
Winthrop
(If nonresident, give city or town and State)
Length of stay: in hospital or institution.
(Before death)
(Specify whether)
years
1
months 1 4
days.
in this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
4 COLOR OR RACE
White
MARRIEDWidowed
WIDOWED
or DIVORCED
5ª If married, widowed, or divorced
HUSBAND of
(or) WIFE of
John Muir
(Giye maiden name of wife in full)
(Husband'e name in full)
6 Age of husband or wife If alive years
7 IF STILLBORN, enter that faot here.
Years Months. Days
If less than 1 day
.. Hours ............ Minutes
Usual
9 Ocoupation :
At Home
11 Soolsi Security No .....
None
12 BIRTHPLACE (City)
(State or country)
Scotland
13 NAME OF
FATHER
Thomas Givan
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Betsy McLean
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
17 Margaret Wickwire
Sister (Address)103 Upland Rd. Winthrop
Winthrop
Physician
1947
1
No.
(If U. S.
War Veteran,
specify WAR)
(Usual place of abode)
Hosp.
R-301 A
PLACE OF DEATH
Suffolk County)
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.
107
§ (If death occurred in a hospital or institution, its NAME instead
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR).
Length of stay: In hospital or Institution
( Before death )
( Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACEI
White
5 SINGLE
( write the word)
Widowed
Sa If married, widowed, or divorced HUSBAND of
(or) WIFE of
Come alive maiden name faite in hilland
( Husband's name In full)
6 Age of husband or wife if allva
years
7 IF STILLBORN, enter that fact here.
8
AGE
76
Years
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupetion :
at home
Industry
10 or Business :
at home
11 Social Security No.
12 BIRTHPLACE (City)
(Siate or country)
Cape Breton
13 NAME OF
FATHER
Henry Oakes
14 BIRTHPLACE DF
FATHER (Clty)
(State or country)
Cape Britan
15 MAIDEN NAME
OF MOTHER
Sophia Perreault
16 BIRTHPLACE OF
MOTHER (City)
(State or country )
Cape Britan
17
mo Mildred Suple( B)
Informant
( Address)
25 Wilshire St
Relation, if any daughter
I HEREBY CERTIFY that a satisfactory standard oartifloale of death was fled with one BEFORE the burist or transit permit was Issued : Walter .....
Health
(Signature of Agreat of Board of Rettth or other) 5/24/47
(Date of Immue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Way.
( Month)
21.1947
(Day)
( Year)
19 May 17 19
HEREBY CERTIFY,
47.
to
attended deosased from
1 last saw
ailva on.
Way 21 1947
death is said to
have occurred on tha dato stated abova, at
1145.0.
m.
Duration
Immediato cause of death Cuenta Pulitocon Eluma
Due to
Due to
Chique Myocardetes
6 laniels
Other conditions.
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Data of.
Of autopsy
What test confirmed diagnosis ?
20 Was disease or injury in any way ralated to oooupation of deceased ? 40
If 00, woolyckan It Schwartz
( Signed)
(Address) 19 Granella ST C. Su850 5123
21
Holy a rose
maldin ...
(City or Town)
Place of Burim, Cremation or Removal.
DATE OF BURIAL
May 24,
19.42
22 NAME OF
FUNERAL DIRECTOR.
Kirby Bros, m. Kirby
ADDRESS
210 Winthrop SI
Received and Aled. 19
MAY 261947
( Reglatras )
1
Winthrop (City or Town} Winthrop Community Hora. No. Clementine Broussard
2 FULL NAME
( If deceased Is a married, widowed or divorced woman, give also maiden name.)
(a) Residenca. No.
(Usual place of abode)
25 Wilshire
St.
(If'nonresident, give elty or town and State)
years
months
2
days.
In this community
yra.
mos.
days.
4
19
IMPORTANT ......
IMPORTANT
Physician Underline the cause to which death should he charged,sta. tistically.
M. 9. 19 .2 ... 7
100m.(g)-1-45.15510
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 reoltal to that effeot. PARENTS
(Oficial Dealgnation)
MARRIED
WIDOWED
or DIVORCED
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, his supposed age, the disease of which be died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by tbe physician or officer and the date of his death ... Gen. Laws, Cbap. 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 be 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 relicf 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 otber 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 110 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 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 caused by violence, tbe 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 sball 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 bereunder. If the death certificate contains a recital, as required
by section ten oi chapier zorty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary information which can be obtained as to the deceased, or as to the 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 shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be 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).
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