USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 61
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15 MAIDEN NAME
OF MOTHER
Annie Jones
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
New Brunswick
(Registrar of Clty or Town where deceased reskdied)
X
No.
(City or Town)
Feter Bent Brigham Hospt
(If U. S.
War Veteran,
specify WAR)
MARRIED
WIDOWED
or DIVORCED
Duranton
R-301 A
PLACE OF DEATH
Suffolk (County) Winthrop (City or Town) No. . - 18 Temple 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 Heafth or its Agent.
Registered No.
185
St. { (If death occurred in a hospital or institution, ( give its NAME instead of street and number) )
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
days.
(If nonresident, give city or town and State)
In this community31
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDMarried
Sa If married, widowdi gripreed o ' Neil 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 58
years
7 IF STILLBORN, enter that fact here.
8 74
AGE
Years
Months
Days
If less than 1 day
.. Hours
Minutes
Usual 9 Occu Meat Brocker
Industry
10 or Business:
Meat
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country)
Ireland
13 NAME OF
FATHER
Unable toblog. Boyle
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Ireland
15 MAIDEN NAME
OF MOTHER
Cannot be learned
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Ir land
17 Informant Minnie Boyle (life). if any ) (Address) 18 Temple Ave
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial pr tragsiy permit was issued: Walter A. Maker (Signature of Menen Board of Wealth or other) , health office (Omhcial Designation) 9/25/47
(Date of issue of yermit)
18 DATE OF
DEATH
September 23
(Month)
(Day)
1947 (Year)
19 I HEREBY CERTIFY,
april 9
. 193 /
to
September 23, 1947
I last saw humM alive on
September 2347, death is said to
have occurred on the date stated above. at 10:15 pm
Duration
Immediate cause of death Sarcoma of left side of week
IMPORTANT 5 yeuro
metastatic Carcomatons 1year Cerchal Nemanlage
5 days 3 days IMPORTANT
Physician
te li Que 23/47 De cause to
Underline
Of autopsy nous which death
What te
should be What test confirmed diagnosis microscopic andred sta- clinical
no
Signed Jacob
(Address: 562
Ahurley St
Date
/M. D.
Place of Burial, Cremation of Removal.
winthrop
Winthropbeting, 20
(City of Town)
DATE OF BURIAL
Sept 26 1947
4/47 a
22 NAME OF FUNERAL DIRECTOR John F . O'mater ADDRESS Winthrop
1
Received and Filed
19
SEP201017 SEP 29 19 H& gistrar)
If dacaased was a U. S. War Vetaran, G. L. Chap. 46, Saction 10, requiras physicians to insart a recital to that effect. PARENTS
100M-7-46-19068
1
2 FULL NAME
Joseph Boyle
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
18 Temple Ave
(Usual place of abode)
St.
Male White
MEDICAL CERTIFICATE OF DEATH
That I attended deceased from
Other conditions
Uremia
(Include pregnancy within 3 months of death)
Major findin
Of operations
Sarcoma of week
20 Was disease or injury in any way related to occupation of deceased?
If so, specify
alamo M. D.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as re- quired by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death .. . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer 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 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 nne 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 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 teu of chapter forty .six, tuat 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 hodies 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 hody 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 form of injury, have died without recent medical attendance or whose phy- sician is ahsent 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 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
4
ORGANIZATION AND OUTFIT
SERVICE NUMBER
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
Øye Commonwealth of passatgustiis OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop. (City or town making return)
186
Registrar's Number
!
St. § (If death occurred in a hospital or institution { give its NAME instead of street and number)
2 FULL NAME
Willard Michael Bacon
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
3. Elmwood Court
(Usual place of abode)
St
(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
years
months
days·
65
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
white
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED widowed
Sa If married, widowed, or divorced
HUSBAND OF
Pauline Emily Haskell
(Give maiden name of
(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 87 Years .2 Months 7. Days
If less than 1 day
Hours ...
Minutes
Usual
·9 Occupation:
retired architect
Industry 10 or Business:
11 Social Security No.
no
12 BIRTHPLACE (City)
(State or country)
Wellsborough
Penny
13 NAME OF
FATHER
James Bacon
14 BIRTHPLACE OF FATHER (City) (State or country)
Charlestown .. N. H.
15 MAIDEN NAME
OF MOTHER
Electa Sanders
16 BIRTHPLACE OF MOTHER (City) (State or country)
Charleston, Penn.
17 Informant (Address) Long Island Ny
Relation, if any
Russell Bacon (. Son )
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with pre BEFORE the burlalor transit permit was issued: aller A. Bakerx. (Snmature of Agent of Board of Health or other) Health Offices (Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Sent
Of ember
1947
(Year)
19 I HEREBY CERTIFY, That I attended deceased from Afx rv .,
199 740
no fx 25
1987
I last saw h ...... alive on Jeff 24, 1947, death is said to have occurred on the date stated above, at 5.300 .p. M.
Immediate cause of death Quemban
coronary
Due to
Due to
Other conditions ungrandex, (Include pregnancy within 3 months of death)
Major findings: Of operations
Date of .
Of autopsy
What test confirmed diagnosis?
Duration Important 3 days
3 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
trut Coller
M.D.
(Signed) Addre
21 Winthrop Cemetery. Place of Burial. Cremation or Removal. (City or Town) DATE OF BURIAL Sent. 27, 1967 19
Winthro P
22 NAME OF FUNERAL DIRECTOR alfred 13 Manche
ADDRESS 174 Winthrop St Winthro
Received and filed SEP 29 1947
19
(Registrar)
A TRUE COPY ATTEST:
1 If deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
on back of certihcate.
100m-(r)-3-46-18278
1
No.
3. Elmwood Court
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
NO
male
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 whoin he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age. the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and fourteen, 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, specifying 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 section 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 nineteen 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 he accompanied, in case of an original inter- ment, 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 physician who is a member of the board of health, or employed by it or by the selectmien for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a perinit 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
of chapter forty-six, that the deceased served in the army. navy or marine corps of the I'nited 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 solgiven and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cuuse of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. h ... (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 received 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 minde. . . . Clmap. 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 tosuch 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 physlclans 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 physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably 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 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 in- 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 cansing 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, 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
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
........
-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No.
Winthrop Community Hosp.
§ (If death occurred in a hospital or institution,
"¿ give its NAME instead of street and number)
Baby Girld Co nklin
( If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
52 Washington Ave
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
f Specify whether)
yeara
months days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCEO
1
5a If married, widowed, or divorced
HUSBANO of
.
(Give maiden name of wife In full)
(or) WIFE of
( Husband's name In full)
6 Age of husband or wife if aliva
years
7 IF STILLBORN, enter that fect here. Stillborn
8 AGE .. ... Yeers Months Oayı
If less than 1 dey Hours Minutes
Usual
9 Occuoetlon :
Industry
10 or Business :
11 Social Security No.
12 BIRTHPLACE (City)
( Siste or country)
Wanthet
Carl P.
13 NAME OF
FATHER
Winfred I Conklin
14 BIRTHPLACE OF
FATHER (Clly)
(Stale or country)
Hartford Clintondal
Gonn. new york
15 MAIDEN NAME
OF MOTHER
Elouiste
Cox
16 BIRTHPLACE OF
MOTHER. (City)
Humble
(State or country)
Texas
( Ad
21
Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Sept. 29
47
19
I HEREBY CERTIFY that a satisfactory standard certificata of daath was filed with me BEFORE the burial or, trangit permit was issued : Walter M. Baking
( Signature of Apat of Board of Health or other)
Health
Oficer
9/29/47
(Oficial Dealmation) (Date of Issue 'of Permity
18 DATE OF
DEATH
27
September
47
( Month)
(Day)
( Year )
19 | HEREBY CERTIFY,
Thet I attended deosased from
19.
to
19
/ last saw h
alive on.
19
., death Is said to
heve occurred on the date stated above, a
1:43 A.
m.
Duration
Immediato ceuse of death Stillborn female
Due to D
· Premature separation of
1
Due to placenta
Other conditions.
( Include pregnancy within 3 months of death)
Mejor findings :
Of operations
Oate of
Of eutopsy Whet test confirmed diegnosis?
IMPORTANT
Physician Underline the cause to which death should be charged sta. tistically .
20 Was disease or injury in any way related jo oooupation of deceased ? If so, spaolfy
( Signed) ...
M. O.
Data /2015
1947
Winthrop
17 Carla Informent
W + Conklin Fathelpatlon, If any ( Address)2 Washington Ave. Winthrop"
22 NAME OF
FUNERAL DIRECTION Sowane Schnell
AOORESS
Received and flad SEP 29 1947
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