USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1947 > Part 81
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13 NAME OF
FATHER
Charles Ruane
Major findings: Of operations
Date of
Of autopsy
What test confirmed diagnosis?
20 Was disease or injury in any way related to occupation of deceased? If so, specify
(Signed)
. M. D.
(Address)
562 Shirley Strath Date Dec .7 1947
Wollaston
Quincy
(City of Town)
Place of Burial, Cremation or Removal.
DATE OF BURIAL
Dec
22 NAME OF
FUNERAL DIRECTOR
ADDRESS Winthrop
Received and Filed
DEC 10 1947
19
(Othcial Designation)
(Date of Issue of Permit 12/8/47
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December . 7℃
(Month)
(Day)
1947 (Ycar)
19
I HEREBY CERTIFY,
That I attended deceased from
now.
5
19
47
. to
Dec 74
.,
I last saw him
alive on
Our ?
19 Y death is said to
have occurred on the date stated above, at
que p m.
Duration
Immediate cause of death
Coronary occlusion
Due to
arterio - sclerotic
Due to
nove
Other conditions
(Include pregnancy within 3 months of death)
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
40
Mrs. Carl Hoffman DagHiespry) 190 Lincoln St
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of Hansit permit was issued: Walter A. Ballers Signature of Agent y Board of Health or other) Health affiche
100M-7-46-19068
(Registrar)
1
47
IMPORTANT / mo.
yrs . . ?
10,74947 19
No. .
(a) Residence. No ..
(Usual place of abode)
3 SEX
4
COLOR OR RACE
Mele
White
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive
7 IF STILLBORN, enter that fact here.
883
Years
Months
Days
Usual
Farmer
9 Occupation:
Farm
Industry
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City)
(State or Country)
Ire land
15 MAIDEN NAME
OF MOTHER
Bridget May
PARENTS
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Ireland
17
Informant
(Address)
If deceased was a U. S. War Veteran, G. L. Chap. 46, Section 10, requires physicians to insert a recital 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
Waty Tunnel, WITH UNPADING BLACK INK - THIS IS A PERMANENT RECORD. Every item of
14 BIRTHPLACE OF
FATHER (City)
(State or Country)
Ireland
PHYSICIAN- IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(If nonresident, give city or town and State)
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 kuowledge 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 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- eian 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 ten or chapter forty-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).
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 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
ORGANIZATION AND OUTFIT SERVICE NUMBER
Uf deceased was a U. S. War Veteran, G. L., Chap. 48. Soc. 10, requires physicians to insert a recital to that effect. PARENTS
100m-(1)-1 15 15510
1
PLACE OF DEAT
Suffolk (County)
Winthrop
(City or Town)
110 Circuit Road
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
St.
¿ give its NAME instead of street and number)
2 FULL NAME
Amelia Elizabeth Rausch
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. .
110 Circuit Road
_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
17yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowe
18 DATE OF
DEATH
(Month)
1
1947
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
ChristianaidRaus ffprife in full)
(or) WIFE of
(Husband's name in full)
have occurred on the date stated above, at /2.25 AM Immediate cause of death.
Duration IMPORTANT
7 IF STILLBORN, enter that fact here.
8
88
AGE
Years
0
Months
13
Dayı
If less than 1 day
Hours.
Minutes
Usual
Housewife
Industry
10 or Business:
At Home
11 Social Security No.
Norre
12 BIRTHPLACE (City)
(State or country)
Germany
13 NAME OF
FATHER
George Rudolph
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Germany
15 MAIDEN NAME
OF MOTHER
Elizabeth Hoerle
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
20 Was disease or Injury in any way related to occupation of deceased ?...
If so, specify
(Signed)
12 miliony
(Address)
Date 12-11- 1947
Everett
Place of Burial, Cremation or Removal.
DATE OF BURIAL
Dec
12
19 47
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed DEC 1 3 1947
_19
A TRUE COPY ATTEST:
(Registrar)
be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so
from the laws on back of certificate. that it may be properly classified. Exact statement of OCCUPATION is very important See instructions and extracts
Amelia Rausch
DaugHteifany
17
Informant
(Addreas)
110 Circuit Rd. Winthrop
I HEREBY CERTIFY that a satisfactory sindard certificate of death was filed withme BEFORE, the burial or transit permit was issued : Watter & garlic
(Signature of Agent/of. Board of Health of other) Health offield 12/12/47
(Official Designation) (Date of Issue of Permit)
Due to.
Cachal Incolision
Due to.
arturo portuno
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Of autopsy
What test confirmed diagnosis?
IMPORTANT Physician
Underline the cause to which death should be charged sta- tistically.
M. D.
21
Woodlawn
(City or Towa)
19
I last saw h La alive on
un 8, 1977, death is said to
" Age of husband or wife if alive. years
19 I HEREBY CERTIFY,
12.15
19
47, to Un 9
That I attended deceased from
(Usual place of abode)
PHYSICIAN-IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
[ (If death occurred in a hospital or institution,
Registrar's No.
249
No.
/
9 Occupation :
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital medical officer sball fortbwith, after tbe death of a persou whom be bas attended during his last illness, at the request of an undertaker or otber authorized person or of any member of tbe 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, wbere 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, Cbap. 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 bundred and four- teen, sball, 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 wbich 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 deatb 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 bundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be decmed to have taken place between February fourteenth, eighteen bundred and ninety-eigbt and July fourtb, nineteen bundred 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 shall bury or otherwise dispose of a buman body in a town, or remove tberefrom a buman body wbich bas not been buried, until be bas received a permit from the board of health, or its agent appointed to issue sucb permits, or if there is no such board, from tbe clerk of the town wbere the person died; and no undertaker or otber person sball 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 be has received a permit from the board of bealtb or its agent aforesaid or from the clerk of the town where the body is buried. No such permit sball be issued until there sball bave been delivered to sucb 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 tbe attending physician, if any, as required by law, or in lieu thereof a certificate as bereinafter 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 wbo is a member of the board of bealtb, or employed by it or by the selectmen for the purpose, sball upon application make the certificate re- quired of tbe 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 buman body, not previously interred, from one town to another within tbe commonwealth cannot be obtained early enough for the purpose, tbe 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, tbat such body shall be returned to the town from which it was removed witbin thirty-six bours after sucb removal, unless a permit in the usual form for the removal of such body has been sooner obtained berennder. 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 United States in any war in which it has been engaged, sucb recital sball 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 tbe cause of deatb 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, wbicb tbe clerk or registrar may require .- Cbap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners sball 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 bis county the body of such a person, be sball fortbwitb_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 buman body or the ashes tbereof which bave 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 wbere the body is to be buried or the funeral is to be beid, or from a person appointed to have tbe care of the cemetery or burial ground in which the interiuent 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 tbe 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 wbo, though disabled by recognized disease unrelated to any form of injury, bave died without recent medical attendance or wbose pby- 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., beart failure, aspbyxia, asthenia, etc. As principal cause name tbe 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 bealtbfulness 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 deatb, report the usual occupation prior to illness. If the deceased bad retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at bome. For a woman whose only occupation was that of bome bousework, write bousework. For a person engaged in domestic service for wages, bow- ever, designate tbe occupation by the appropriate terms, as housekeeper- private family, cook-botel, etc. For a person wbo bad no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT SERVICE NUMBER
PLACE OF DEATH
Suffolk (County)
No. Winthrop Community Hospital
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registrar's No. 250
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)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
14 George Street
yoars
months
1
days.
In this community
yTE.
mos.
days.
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
December
11
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deceased from
nov. 25-
1947.
to December 11
1947
I last saw hism alive on Dec 11. 19 47 death is said to have occurred on the date stated above, at 9.40 PM. Immediate cause of death Hypertensive Heart Disease
Duration IMPORTANT 4 years
10 years
20
Dne to
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of
Of autopsy.
none
What test confirmed diagnosis? clinical
20 Was disease or Injury in any way related to occupation of deceased ?. 210 If so, specify-Q Jurdie ou putin MAL, M. D.
(Slg
(Address)
Winthrop Mars Date 12/12 1947
Place of Burial, Cremation Ref (City or Towa)
DATE OF BURIAL Dec -15 1947
22 NAME OF FUNERAL DIRECTOR ADDRESS
Received and filed DEC: 1 31947 19
A TRUE COPY ATTEST:
IMPORTANT Physician
Underline the cause to which death should be charged sta- tistically.
100m- (1)-1-45-15510
1
Winthrop
(City or Town)
2 FULL NAME
Otis P Waite
(Usual place of abode)
Length of stay: In hospital or Institution
Hosp.
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
male
4 COLOR OR RACE
White
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed, or divorced
HUSBAND of
(or) WIFE of
(Give maiden name of wife in full)
(Husband's name in full)
7 IF STILLBORN, enter that fact here.
8
AGE 86
Years 8 Months
- Days
Usual
(years)
9 Occupation :
Retired
11 Social Security No.
12 BIRTHPLACE (City)
Milford
(State or country)
13 NAME OF
John D. Traite
FATHER
14 BIRTHPLACE OF Worcester
FATHER (Cit)
(State or country)
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
England.
17
that It may be properly classified. Exact statement of OCCUPATION is very Important See instructions and extracts
De curviuly suppued. AGE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH in plain terms, so
Industry
10 or Business:
Livery Business
from the laws on back of certificato.
Uf deceased was a U. S. War Veteran, G. L., Chap. 48. Sec. 10, requires physicians to Insert a recital to that effect.
PARENTS
If less than 1 day Hours. Minutes
15 MAIDEN NAME
OF MOTHER
marcha Sengeni
Oliswant Bartad Inera Relation, if any
I HEREBY CERTIFY that a satisfactory standard certificate of death fled with me BEFORE the burial or transit permit was issued: Walter A. Makerg
(Signature of Agent of Board of Health of other), Thealte officer 12/12/47 data Designatlon) (Date of Issue of Permit)
St.
(If nonresident, give city or town and State)
1947
5 SINGLE
(write the word)
Dingle
" Age of husband or wife if alive. years
Due
to
arterio-seleraich
Cancer Dutie neck
(Registrar)
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