USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 67
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183
2 FULL NAME P Frank W Penney Franke Les -
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
186 Highland Ave .
St.
(Usual place of abode)
Length of stay: In hospital or institution.
Hosp.
years
months
3
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
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.
74
years
7 IF STILLBORN, enter that fact here.
8
79
Years
9.
Months
3 Days
If less than 1 day
Houre
Minutes
9 Occupation:
Machinist
10 or Business :.
Retired
11 Social Security No. 031-10-8734A
12 BIRTHPLACE (City) .. S.kowhegan
(State or country)
Maine
13 NAME OF
FATHER
Henry Penney
14 BIRTHPLACE OF
Skowhegan
FATHER (City)
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Ann Conant
16 BIRTHPLACE OF
MOTHER (City)
Topsham
(State or country)
Maine
Informant. Merle D Penney
Relation, if any Son
(Address)
71 Waldemar Ave, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of traneit permit was iseued : Maltte F. Walker
(Signature of Agent of Board of Health of other)
9/18/48
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
17
1448 (Year)
19
I HEREBY CERTIFY,
9-14-,
19
4800
9-17, 1948
I last saw h alive on
4-12, 1946, death is said to
have occurred on the date stated above, at
11.15 A
.m.
Immediate cause of death ....
Duration IMPORTANT
Due to.
Due to.
Other conditions. (Include pregnancy within 3 months of death)
Cepregnant
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, epecify
(Signed)
22/2016 Date ://1/1948
(Address)
21 Pine Grove
Waterville Me.
Place of Burial, Cremation or Removal.
(City or Town)
Sept. 20
48
DATE OF BURIAL.
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed
19
500 1345
(Registrar)
100m-2-'40-D-729-a
1 3 SEX Male AGE. Usual PARENTS 17 CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and extracts from the laws on back of certificate. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state Industry
Winthrop Community Hospital No ...
§ (If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
(If U. S.
War Veteran,
epecify WAR)
(If nonresident, give gity or town and state)
38
(Specify whether)
Florence Bradbury
(Day)
That I attended deceased from
IMPORTANT
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
M. D.
Registered No
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer sball 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 liis knowledge and belief the name of the deceased, his supposed age, the disease of which he died, definded as required by section one, where 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, Chap. 46, Sec. 9.
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 otber 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 receiv- ing tomb to anotber in the same cemetery, until he bas received a permit from the board of health or its agent aforesaid or from the clerk of tlie 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or by the selectmen for the purpose, shall upon application inake the certificate required of the attending physician. If deatb is caused by violence. the medical examiner shall inake such certificate. If such a permit for the removal of a human body, not previously interred, from one town to anotber 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 re- moval of such body has been sooner obtained bereunder. If the deatb certificate contains a recital, as required by section ten of chapter forty- six, tbat 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 tbe 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 furnislı for registration any other necessary information which can be obtained as to the deceased, or as to tbe manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
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 tbe 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 physielans 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 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 tbe 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 wbicb causes death, not the mode of dying, e. g., heart failure, aspbyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, nanie earlier morbid conditions, if any, related to tbe principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation Is very important, 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 cbanged 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 home. For a woman wbose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate tbe occupation by tbe appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person wbo had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION.
M R-302
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
PLACE OF DEATH
Essex (County)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF
CERTIFICATE OF DEATH
Hathorne Mass.
S (If death occurred in a hospital or institution, give ite NAME instead of etreet and number)
2 FULL NAME
Henry A. Cherry
(If deceased ie a married, widowed or divorced woman, give also maiden name.)
(a) Residenoe.
No.
41 Mermaid Ave. , Winthrop, Massg
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay : In hospital or Institution
(Before death)
(Specify whether)
years
2
monthe
2
days.
In this community
yre.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE|
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Divorced
(Month)
(Day)
(Year)
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
(Husband'e name in full)
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that faot here.
8
AGE
65 Years Months ... Days
If less than 1 day .Hours .Minutes
Usual
9 Ocoupation :
Dentist
Industry 10 or Business :
11 Soolal Security No ..
12 BIRTHPLACE (City)
(State or country)
Russia
13 NAME OF
FATHER
Jacob Cherry
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Russia
15 MAIDEN NAME
OF MOTHER
Ida Freidman
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Russia
17
Informant
Mary K. McPhillips(
Relation, if any
(Addrese)
Hathorne Mass.
A TRUE COPY.
ATTEST:
Want Than
(Regietrar of city or town where death occurred)
DATE FILED Sept. 28 19 48
19 | HEREBY CERTIFY,
That I attended deceased from
Cannot be learned July 19 19 48 to. S.e.p.t ..... 21
19
48
I last saw h
im
.allve on
Sept. 21
1948
death Is sald to
have ocourred on the date stated above, at.
11:00p
m.
Duration
Immediate oause of death
Arteriosclerotic heart disease
...... y.r.s .-
Due to
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of.
should be charged sta. tistically.
Of autopsy
What test confirmed dlagnosis?
Clinical
no
20 Was disease or Injury in any way related to oooupatlon of deceased ?.
If so, speolfy
Francis X. Sullivan
(Address)
21 PLACE OF BURIAL, Ohav-Zedek
CREMATION OR REMOVAL ..
(Cemetery )
(City or Town)
DATE OF BURIAL
Sept. 23
19 48
22 NAME OF
FUNERAL DIRECTOR
H. J. Torf
ADDRESS
Chelsea, Lass.
Reoelved and filled.
OCT 8 1948
19
(Registrar of City or Town where deceased resided)
50m-(b)-6-44-14607
1 Danvers
Registered No.
1.88 ....
(City or Town) NoDanvers State Hospital ..
Danvers
(City or town making return)
(If U. S.
War Veteran,
speolfy WAR)
18 DATE OF
DEATH
September
21
1948
Underline the catee to which death
(Signed)
Hathorne, mass.
Date
9/24 , 48
West Roxbury
(Give maiden name of wife in full)
-301
from the laws on back of certificato.
100m. (f)-1-45-15510
I HEREBY CERTIFY that a satisfactory standard certificate of death way hled with me BEFORE the burial or transit permit was issued: Watter & Makeit
Health
(Signature of Agent of Board of Health 923/48
7(Oficial Designatlon) . (Date of Issue of Permity
MEDICAL CERTIFICATE OF DEATH
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
18 DATE OF
DEATH
Sept.
21
1948
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
Lura C Wheeler
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
56
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
8
AGE
56 Years
2 Months.
20Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation :
Salesman
Industry
Oil Concern
10 or Business :
11 Social Security No.
011-05-3390
Appleton
12 BIRTHPLACE (City)
(State or country)
Maine
13 NAME OF
FATHER
Lindley M Gushee
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
15 MAIDEN NAME
OF MOTHER
Helen J Sherman
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass.
17 Lura C Gushee WWifeif any
Informant
(Address)
204 Cottage Park Rd. Winthro
O
DATE OF BURIAL
Place of Burial, Cremation or Removal.
Sept
23
(City or Towa)
,48
19
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
10 minos meus
Received and filed. SEP 2/ 1948
_19
A TRUE COPY ATTIST:
6 sicas 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 ? 30
If so, specify
na. S. D.
(Signed)
M. D.
(Addre Winthrop, Mass Dat Sept 21 19/8 winthrop
Duration IMPORTANT Sudden
Due to.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Date of.
-
Of autopsy
What test confirmed diagnosis ?!
Clinical Signs
If deceased was a U. S. War Veteran, G. L., Chap. 48, Sec. 10, requires physicians to insert a recital to that effect. PARENTS
PLACE OF DEATH.
+
Suffolk
(County)
1
Winthrop
(City or Town)
No. 204 Cottage Park Road
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
Registrar's No.
189
St. § (If death occurred in a hospital or institution, [ give its NAME instead of street and number)
3 FULL NAME
Harry Nelson Gushee
(If deceased is a married, widowed or divorced woman, give also maiden name.)
204 Cottage Park Road
(a) Residence. No.
(Usual place of abode)
St.
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
WW#1
Length of stay: In hospital or Institution
(Before death)
(Specify whether)
years
montha
days.
(If nonresident, give city or town and State)
In this community 30yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
19 I HEREBY CERTIFY,
That I attended deceased from
Sept 20.
-
to
Sept 21
1948
I last saw h / by alive on
Sept 21, 1940, death is said to
have occurred on the date stated above, at 5.300 M.
Immediate Cause of death
Coronary / hrouhous
acalientes
Appleton
Haverhill
21
Winthrop
1
(Registrar)
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a persou whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and helief the name of the deceased, his supposed age, the disease of which be 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 bis death ... Gen. Laws, Chap. 46. Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or hy 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 hoth 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, 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 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 nndertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not heen 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 he, a satisfactory written statement containing the facts required by law to he returned and recorded, which shall be accompanied, in case of an original interment, hy a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot he obtained early enough for the purpose, or is insufficient, a physi- cian who is a member of the board of health, or employed hy it or hy the selectmen for the purpose, shall upon application make the certificate re- quired of the attending physician. If death is caused by violence, the medi- cal examiner shall make such certificate. If such a permit for the removal of a human 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 ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such hody 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 herennder. If the death certificate contains a recital, as required
by section ten ui chapter toriy-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 deatb shall thereafter furnish for registration any other neces- sary information which can he obtained as to the deceased, or as to the tanner 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 hy violence. If a medical examiner has notice that there is within bis 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 hoard, from the clerk of the town where the body is to he huried or the funeral is to he held, cr 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 wben 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 deatbs following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled hy recognized disease, and those of persons found dead.
Statement of Cause of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name 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 healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, how- ever, designate the occupation 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
Counyy) 1 Auffällt. Millical (City or Town), Autepatrick Rest Horne No. PLACE OF DEATH
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.
190
St. [ (If death occurred in a hospital or institution. ( I give its NAME instead of street and number) }
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(If nonresident, give city or town and State)
In this community
20 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE
While
5 SINGLE (write the word)
MARRIED
WIDOWED
or DIVORCED
5a If married, widowed or divorced HUSBAND of .
(Give maiden name of the in full)
(or) WIFE of
(Husband's name in funf)
6 Age of husband or wife if alive years
7 IF STILLBORN, enter that fact here.
8
AGE
Years
Months
Days
If less than 1 day
. Hours
Minutes
Usual
9 Occupation:
Home
Industry 10 or Business:
11 Social Security No.
12 BIRTHPLACE (City) (State or Country)
Kebeter Mais
13 NAME OF
FATHER
Patrick perable to
obtain
L
14 BIRTHPLACE OF FATHER (City) (State or Country)
Inland.
15 MAIDEN NAME OF MOTHER
Trident O Connor
16 BIRTHPLACE OF
MOTHER (City)
(State or Country)
17 Kalkle Hever (Relation any )
Informant (Address 15- Anglesiile Mal
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed withme BEFORE the burial of transit permit was issued: Haller & Khaberg Signature of Agent of Board of health or other)
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