Town of Winthrop : Record of Deaths 1949, Part 3

Author: Winthrop (Mass.)
Publication date: 1949
Publisher:
Number of Pages: 456


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1949 > Part 3


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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 (City or Town) 35 Centre St. John Peter Petersen


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH


Registered No.


To be filed for burial permit with Board of Health or its Agent.


J(If death occurred in a hospital or institution. St. Į give its NAME instead of street and number)


PHYSICIAN - IMPORTANT


(If deceased is a married, widowed or divorced woman, give also maiden name.)


(a) Residence. No. 35 Centre St (Usual place of abode)


St.


(If nonresident, give city or town and State)


Length of stay: In place of death 52 years. months. .days. In place of residence .years .months .. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


gan


&.Month)


11 (Day)


49


(Year)


8 SEX


Male


9 COLOR OR RACE


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Vidowė d


4 I HEREBY CERTIFY,


That I attended deceased from


may


19


48


to.


I last saw h. W. alive on


quipe 11, 1949 death is said to


have occurred on the date stated above, at 12º P.m.


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Cancunning


y Julesticas


INTERVAL BE- TWEEN ONSET AND DEATH 9 mos


11 IF STILLBORN, enter that fact here.


12


AGE


79


Years


Months .


Days


If under 24 hours


Hours


Minutes


13 Usual


Occupation :


Marine Engineer


(Kind of work done during most of working life)


14 Industry


or Business :.


Steamship


15 Social Security No.


16 BIRTHPLACE (City) (State or country) Denmark


17 NAME OF


FATHER


Peter petersen


18 BIRTHPLACE OF


FATHER (City)


(State or country)


Denmark


19 MAIDEN NAME


OF MOTHER


Cannot be learned


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


Denmark


Jalter Petersen


7 NAME OF


FUNERAL DIRECTOR


ADDRESS


Winthrop Mass


Received and filed


19


JAN 1 7 1949


(Registrar)


PARENTS


5 Was disease or injury in any way related to occupation of deceased?


If so, specify


(Signed)


(Address) 2001 Causant Date 1ay 12


M. D.


49


6


Woodlawn


Place of Burial or Cremation


Everett


(City or Town)


DATE OF BURIAL


January 14


19 49


21 Informant (Address) 35 Centre St Vrthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter & Bakes. (Signature of Agent of Board of Health or other) Health Officer 1/13/49 (Official Designation) (Date of Issue of Permit)


RUCTIONS FOR . CERTIFICATE


giving OF DEATH not enter than one for each (b) and (c)


does not mean of dying, such ilure, asthenia .. ans the disease, ications which ath.


id conditions, ving rise to the se (a) stating rlying cause


itions contrib- e death but not the disease or causing death.


Major findings:


Ul Operations Caccinina y Palestinas


Date of operationmay //T 22 Was autopsy performed?


What test confirmed diagnosis ?. -


10a If married, widowed, or divorced


HUSBAND of. Nellie A. Garvey


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


ANTE


Due To


CEDENT (b)


CAUSES


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Sendetiro Salemarino


2yrs.


100M-(D)-10-48-24658


M R-301A 1


2 FULL NAME ..


(Was deceased a U. S. War Veteran, if so specify WAR)


19


49


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 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 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, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate 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 shallexhume 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 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 selectmen 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 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 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, 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 registra- tion. The person to whom the permit isiso given 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 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 persons 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 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 follow- ing 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 deathsonly 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 .- Physicians: see explanatory instructions on face side of standard certificate of death,


Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. 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


M R-301A 1


PLACE OF DEATH


- Suffolk (County)


Winthrop (City or Town) 55 Court Rd. 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.


8


f(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)


Margaret (Ramsay ) Beach


2 FULL NAME ..


(If deceased is a married, widowed or divorced woman, give also maiden name.) 55 Court Rd.


St.


(If nonresident, give city or town and State)


Length of stay: In place of death. ...... .. years .. .. months. .days. In place of residence


39


.years


months


.days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR OR RACE White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married


4 I HEREBY CERTIFY,


That I


attended deceased from


49


I last saw h ..... alive on.


January 13 1949, death is said to


have occurred on the date stated above, at


-5:20 P.m.


(or) WIFE of


Edgar Beach


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


acute Coronary Thrombosis


INTERVAL BE- TWEEN ONSET ANO DEATH 12 hours


11 IF STILLBORN, enter that fact here.


12


AGE


75


Years


1


Months.


22


.Days


If under 24 hours


Hours .... . Minutes


ANTE CEDENT CAUSES


arterioscleratic and


(b)


hypertensive heart disease


(c) Due To arteriosclerosis


2 years


15 Social Security No.


None


16 BIRTHPLACE (City)


(State or country)


III.


17 NAME OF


FATHER


Robert Ramsay


18 BIRTHPLACE OF


Hamilton


FATHER (City)


(State or country)


Scotland


19 MAIDEN NAME OF MOTHER Agnes Wellwood


20 BIRTHPLACE OF


Glasgow


Scotland


21 Informant (Address)


Robert Beach 55 Court Rd. Winthrop


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


Walter & Baker (Signature of Agent of Board of Health or other)


Healtle Affer


1/11/49


(Date of Issue of Permit)


100M·(D)-10-48-24658


Received and filed 19


JAN 1 7 1949


(Registrar)


PARENTS


5 Was disease or injury in any way related to occupation of deceased ?.


If so, specify .... . .......


(Signe


(Address) 562 Sheley St.


Winthrop


6


Winthrop


Place of Burial or Cremation (City or Town)


DATE OF BURIAL


Jan.


17


19 49


7 NAME OF


FUNERAL DIRECTOR


Haward S Pugnale


ADDRESS Winthrop mais


Date Jose. 13 19 49 MOTHER (City) (State or country)


Chicago


Major findings:


Of operations.


none


Date of operation.


Was autopsy performed ?. .


What test confirmed diagnosis? Clinical + laboratory.


13 Usual


Occupation:


Housewife


(Kind of work done during most of working life)


2 years 14 Industry


or Business:


Own Home


OTHER


SIGNIFICANT


CONDITIONS


January 13 1949 (Year)


3 DATE OF DEATH


(Month)


(Day)/


January 22,


19


47.


to ..


January 13


19


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(a) Residence. No. (Usual place of abode)


TRUCTIONS FOR IL CERTIFICATE


n giving OF DEATH not enter e than one se for each , (b) and (c)


s does not mean e of dying, such failure. asthenia, eans the disease. lications which eath.


bid conditions. iting rise to the use (a) stating lerlying cause


ditions contrib- he death but not the disease or causing death.


1) Maurice traunstein .fr


M. D.


Registered No.


"(Official Designation)


10a If married, widowed, or divorced


HUSBAND of.


(Give maiden name of wife in full)


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 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 four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the arrny, 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 imme- diate 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 shallexhume 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 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 selectmen 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 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 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, 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 registra- tion. The person to whom the permit is so given 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 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 persons 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 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 follow- ing 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 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 .- Physicians: see explanatory instructions on face side of standard certificate of death.


Statement of Occupation .- Precise statement of occupation is very import- ant, 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 occup :.- tion had been given up or changed, or if the deceased had retired from business. report the kind of work done during most of working life even if retired. 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


R-301 A


+ Suffolk (County) Winthrop 1 (City or Town) Winthrop Community Hospital No. PLACE OF DEATH Baly Bay miller


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.


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) no


2 FULL NAME


(If deceased/s a married /widowed or divorced woman, give also maiden name.)


(a) Residence. No. 517 loyd


(Usual place of abode)


Length of stay: In hospital or institution


(Before death)


Hosp.


(Specify whether)


years


5 hrs 10


months min


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


3 SEX male


4 COLOR OR RACE


White


5 SINGLE (write the word)


MARRIED


WIDOWED


or DIVORCED


Single


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.


8 AGE Years Months Days


If le s than 1 day . Hours 10 Minutes


Usual


9 Occupation:


none


Industry


10 or Business:


none.


11 Social Security No.


nome


12 BIRTHPLACE (City).


(State or Country)


Winthrop mass


13 NAME OF


FATHER


Leslie Er miller


PARENTS


14 BIRTHPLACE OF


Rever


FATHER (City)


(State or Country)


mass


15 MAIDEN NAME


OF MOTHER


Sylvia Stockman


16 BIRTHPLACE OF


MOTHER (City)


(State or Country)


Boston


mass


17 Leslie R. miller


(Address) 517 lag ast Winchings


I HEREBY CERTIFY that a satisfactory standard, certificate of death was filed with me BEFORE the burial or transit permit las issued: Walter At . Baleares Signature of Agent of Board of Health another) Heatthe officer (Official Designation) (Date of Issue of Permit) 1/18/49


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


Chroni


18 (Day)


1949 (Year)


19 I HEREBY CERTIFY, That I attended deceased from


Jan.


17


49. to


jan 18


, 19


,


19


49


I last saw h.


alive on


Jun.


have occurred on the date stated above, at


17. 19 19, death is said to 130 A. m.


Duration IMPORTANT


IMPORTANT


Physician Underline the cause to which death should be charged sta- tistically.


20 Was disease or injury in any way related to occupation of deceased? If so, specify (Signed) huis Singel , M. D.


(Address)


72 July An Run Date 1/18


19 4 P


Event


21


Place of Burial, Cremation or Removal.


(City or Town)


DATE OF BURIAL


January 19


1949


N. J. Jork


ADDRESS


22 NAME OF


FUNERAL DIRECTOR


5. Washington ami. Chelsea


Received and Filed JAN 2 8 1949 19


(Registrar)


X


Due to


Prematurity


Due to


Placenta Previa


Pracacom


Other conditions


(Include pregnancy within 3 months of death)


Major findings: Of operations


Date of


Of autopsy


What test confirmed diagnosis?


Relatiory, if any ) Faches


100M-7-46-19068


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.




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