USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 14
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ADDRESS 23 Carry avec & ladica
Received and Filed MAR 1 1943
19
(Registrar)
{
Duration
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
-
100m-9-44-14955
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 classined. Exact Statement of OGCuration is very important. PARENTS
(a) Residence. No. 46 WASHINGTON AVE WINTITROS !. (Usual place of abode)
Length of stay: In hospital or institution INSTITUTION
years
8 months
days.
(Before death)
(Specify whether)
St.
-
2 FULL NAME
ELIZABETH CORRIGAN
(If deceased is a married, widowed or divorced woman, give also maiden name.)
FEMALE
WHITE
MEDICAL CERTIFICATE OF DEATH
48
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 seetion 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, See. 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 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 uo undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to 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- eal 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 auch 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, 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, See. 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 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 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 ueeded.
(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, hut 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 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
(or) WIFE of
8
AGE
73 cars.
Industry
10 or Business :
13 NAME OF
FATHER
14 BIRTHPLACE OF
FATHER (City)
15 MAIDEN NAME
OF MOTHER
PARENTS
(State or country)
Informant
(Address)
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-802 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
(State or country)
4 COLOR OR RACE|
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
ar
5a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
6 Age of husband or wife If allve yeara
7 IF STILLBORN, enter that faot hers.
If less than 1 day
Hours
Minutes
Usual
9 Oooupation :
Office Furniture
11 Social Security No 010-07-5397 A
12 BIRTHPLACE (City)
(State or country)
Rochester NY
charles Russell
Koene - II
16 BIRTHPLACE OF
MOTHER (City)
...
Rochester NY
17 William
Russell
Relation 11 any
Hingham
A TRUE COPY.
ATTEST:
Chester L. Google
(Registrar of city or town where death ofcored) 1948 DATE FILEDOWN Clerk 19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
fob 14
1948
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY,
2/1/2019.
to
I last saw h
ativo on
2/12/
19 ...
48
m.
Duration
Immediate oause of death.
broncho Pneumonia
4 Days
Due to
Due to.
Other conditions.
Ganmamtorio Scippowgs
(Include pregnancy within
Major findings :
Of operations
Date of
should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?.
20 Was dissass or injury in any way related to oooupation of deceased? If so, spsolfy.
(Signed)
M. D.
(Address)
John F HeardonDate.
19.
2/16/ 48
CREMATION ORIREMOVAL Con winthrop or Town)
DATE OF BURIAL
Feb 17
19 ..
48
22 NAME OF
FUNERAL DIRECTOR
John Pyne
ADDRESS
Hingham
Feb 16 1948 19
Received and filed
(Registrar of City or TOWAR 1 6 1943
50m - (b) -6-44-14607
PLACE OF DEATH
Norfolk'
(County)
1
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Weymouth
(City or town making return)
-34
Registered No.
(If death occurred in a hospital or institution,
St.
give ita NAME instead of street and number)
2 FULL NAME
Ralph ........ Russell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
380 Pleasant
St.
Winthrop
(If nonresident, give city or town and State)
(Usual place of abode)
Length of stay : In hospital or Institution ..
(Before death)
(Specify whether)
years
months
day 8.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
No.
XXXXXX Nursing HOMO
(If U. S.
War Veteran,
speolfy WAR)
-
That I attendsd deceased from
death Is sard to
hava ocourred on the date stated above, at
4:45
P
Underline the cause to which death
Emma Babcock
21 PLACE OF BURIAL,
Main St
Months ..
Days
+
R-301 A
1
PLACE OF DEATH No.
Suffolk (County)
Winthrop (City or Town) 26 Jefferson 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.
36
St.
(If death occurred in a hospital or institution,
give its NAME instead of street and nun.ber) !
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR) {
(a) Residence.
No.
26
Jefferson St
St.
(Usual place of abode)
Length of stay: In hospital or institution
(Before death)
(Specify whether)
ycars
months days.
In this community+O
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4
COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Female white
Widowed
5a If married, widowed or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
Thomas . F. Cassens
(Husband's name in full)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8 AGE 66 Years
Months
Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Housewife
Industry
10 or Business:
Own
Home
11 Social Security No.
Belfast
12 BIRTHPLACE (City)
(State or Country)
Me
13 NAME OF
FATHER
George Wenthorth
14 BIRTHPLACE OF
FATHER (City)
Naldo
(State or Country)
Me.
15 MAIDEN NAME
OF MOTHER
Lydia A. Johnson
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
Maine
17 InformantJohn
Cassens
Relation, if any ) Son
(Address)
26 Jefferson St.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial qr transit permit was issued: Walter f Waker (Signature of Agent of Board of Health or other) 3/8/48
Lealle Officer / (Official Designation) (Date of Issue of Pergnits
18 DATE OF
DEATH
( Month)
6 (Day)
1948 (Ycar)
48
I last saw h
alive on
, death is said to
have occurred on the dale stated above, at
4.03 P
m.
Duration
Immediate cause of death
CORONARY
EMboliSA
Due to MYOC/ARditis
arturo palavras
Due to
ARTERio
(sclerosis
Dubito mellitus
Other conditions (Include pregnancy within 3 months of death) Diabetes Mellitus
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
Charles 7 wahrmay.
(Signed)
(Address)
21
Holy
Cross
Malden
Place of Burial, Cremation or Removal.
(fity or Town)
DATE OF BURIAL
March 904948/1
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Received and Filed
19
MAR 1 0 1948 (Registrar)
See instructions and 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 recital to that effect. PARENTS
100M-7-46-19068
19 HEREBY CERTIFY.
That I attended deceased from
Selit , 1942 .to
, 19
IMPORTANT
IMPORTANT
Physician Underline the cause to which death should be charged sta- tistically.
7-8- 1948
2 FULL NAME
Gertrude
M. Wentworth'
Cassens
(If deceased is a married, widowed or divorced wor .r . A ve also maiden name.)
(If nonresident, give eity or town and State)
MEDICAL CERTIFICATE OF DEATH
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 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 bundred 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, 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 witbin 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 bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person sball bury a human body or the 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
+
R-301 A
1
PLACE OF DEATH
Suffolk
(County) Winthrop 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.
37
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)
(a) Residence.
No.
154 Bowdoin
St.
(If nonresident, give city or town and State)
(Usual place of abode)
Hospital
months
4
days.
In this community
17 yrs.
mos.
days.
Length of stay: In hospital or institution
(Before death)
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
3 SEX Feriale
4 COLOR OR RACE
White
MARRIED
WIDOWED
or DIVORCED
5 SINGLE
(write the word)
Widowed
5a If married, widowed or divorced
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 years
7 IF STILLBORN, enter that fact here.
00 AGE ..
64
Years
Months
Days
If less than 1 day
. Hours
Minutes
Usual
9 Occupation:
Housework
Industry
10 or Business:
Own Home
11 Social Security No. More
12 BIRTHPLACE (City)
(State or Country)
13 NAME OF
FATHER
Solen Gunnarson
14 BIRTHPLACE OF
FATHER (City) ..
(State or Country}
Sweden
15 MAIDEN NAME
OF MOTHER
Mary Dalas
16 BIRTHPLACE OF MOTHER (City) (State or Country) Ireland
17 Informant (Address 154 Bowdoin Il Wann
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with, me BEFORE the burial or/ transit permit was issued: Walter A- Pakker 3/10/48 (Signature of Agent of Board of Health of other) Health Officee (Official Designation) (Date of Issue of Permity
19
I HEREBY CERTIFY.
That I attended deceased from
December 22
1943, to
March 6
19 48
I last saw her alive on
March 6. 19 40 death is said to
have occurred on the date stated above, at
11:35 p.m.
Immediate cause of death Cerebral Embolso
mitral Stenosis
Due to
Othe
IMPORTANT
Terminal Bronchio- 3 days.
(Include pregnancy within 3 months of death)
Precision a
Major findings:
Of operations
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