USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 77
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death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy nr 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 persons as are supposed to have died by violence. or by the action of chemical, thermal or electrical agents or following abortion, or fromn diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, nr when any person is found dead. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
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 deccased had retired from business, report the kind of work done during most of working life even if retired. Chiklren 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-303 A 1
PLACE OF DEATH Suffolk County)
Winthrop ... (City or Town monte to Winthrop Commun
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or ite Agent.
Registered No.
J(If death occurred in a hospital or institution.
St. { give its NAME instead of street and number)
and
(If deceased is a married, widowed or divorced woman, give also maiden name.)
6 Seplan
on It Wintham
(If Aghresident, give city or town and State)
Length of stay: In place of death ....... years. months. days. In place of residence. .2 ... years
.months.
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
Male
10 COLOR OR RACE
White
11 SINGLE
(write the word)
MARRIED
WIDOWED
(Month) (Day) (Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.)
11a If married, widowed,
HUSBAND of
JohanHaceDungan
(Give maiden name of wife in full)
Corona
(or) WIFE of.
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE
7 Years
.Months.
.Days
If under 24 hours
Hours.
Minutes
14 Usual
OccupationRetired Custodian
(Kind of work done during most of working life)
15 Industry
or Business:
School
16 Social Security No.
17 BIRTHPLACE (City)
(State or country)
East Boston
Mass
18 NAME OF FATHER
Samuel
19 BIRTHPLACE OF
FATHER (City)
(State or country)
Maine
20 MAIDEN NAME
OF MOTHER
Mellisa Poole
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Maine
22
Informant
(Address)
420
Winthrop St
James .......
Hannaford.
DATE OF BURIAL
(City or Town) ... 1950
8 NAME OF
FUNERAL DIRECTOR
Winthrop
ADDRESS
Received and filed.
DEC 13 1950
19
(Registrar)
PARENTS
6 Was disease or injury in any way related to occupation of deceased?
Luongo
M. D.
(A dress) 25 Shathick St Date 12/9 1950
Winthrop
Winthrop
50m-(g)-10-48-24658
place? Injury 7 If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. If so,
Every item of
N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD.
of Death. DEATH in plain terms, so that it may be properly classified under the International Classification of Ceuses information should be carefully supplied. MEDICAL EXAMINERS should stato CAUSE AND MANNER OF See reverse side for extrects from the laws relative to the return of certificates of death.
Where did Injury occur? (City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
(Specify type of place)
Manner of
(How did injury occur?)
Nature of
Injury
While at work?
Was autopsy performed?
no
(Signed)
Place of Burial, or Cremation
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Watter & Bakes
(Signature of Agent of Board of Health or other). 15DE 11/1950
(Official Designation) (Date of Issue of Permit)
PHYSICIAN - IMPORTANT
J (Was deceased a U. S. War Veteran, ( if so specify WAR)
(a) Residence. No. (Usual place of abode)
...
2 FULL NAME .. Jan
December 8, 1950
3 DATE OR
DEATH
5 Accident, suicide, or homicide (specify)
Date and hour of injury
19
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 lwith any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall. for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall 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. as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931. No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits. or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made ......... Chap. 114, Sec. 46, G. L., as amended.
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead ....... - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident.""Pistol shot wound of the chest with associated hemorrhage, hom- icidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1)Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE. RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
M R-302 1
PLACE OF DEATH
Suffolk (County)
Boston
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Baston (City or town making return)
Registered No.
f(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
John F. Kelly
(If deceased is a married, widowed or divorced woman, give also maiden name.)
59 Crest Ave.
Winthrop
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
.years ..
months.
2.days.
In place of residence.2 years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
(Month)
(Day)
(Year)
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Married
4 I HEREBY CERTIFY,
Dec.6
50
That I _attended deceased
Dec.8
from
50
19
death is said to
have occurred on the date stated above, at
2;20A
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TWEEN ONSET AND DEATH 1 Mo.
11 IF STILLBORN, enter that fact here.
12
AGE
Years
Months.
Days
64
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Mailing Clerk
(Kind of work done during most of working life)
14 Industry
or Business:
Newspaper Co.
15 Social Security No ............
16 BIRTHPLACE (CityCharlestown Mass. (State or country)
17 NAME OF
FATHER
Edward J Kelly
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Haverhill Mass.
Date of operation
Was autopsy performed?
Yes
What test confirmed diagnosis ?.
autopsy
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify.
(Signed)
L Lezer
Mass. General Hospit 12-8
(Address)
Winthrop Cem-Winthrop Mass.
DATE OF BURIAL
Dec. 11/50
19
7 NAME OF
M W Kirby
FUNERAL DIRECTOR
ADDRESS
nthrop Mass.
Received and filed. 19
(Registrar of City or Town where deceased resided)
PARENTS
19 MAIDEN NAME
OF MOTHER
Margaret Hughes
20 BIRTHPLACE OF
Malden Mass.
M. D. 501 MOTHER (City) (State or country)
21
Informant
(Address)
Mrs John Kelly
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Dec. 12/50
19
25m-(b)-11-49-900.475'
3 DATE OF
DEATH
CEDENT (b)
CAUSES
6
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible
CONDITIONS
ANTE Due To Chronic nephrosclerosis 6 Mos
Due To (c)
OTHER
Pulmonary edema
SIGNIFICANT
Major findings:
Of operations.
None
Hrs.
10a If married, widowed, or divorced
HUSBAND of
MaryF Macdonald
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
TO DEATH (a)
Uremia
19
to
Dec.8
I last saw
h
im.alive on
1950
m.
Dec. 8/50
(Was deceased a U. S. War Veteran, go specify WAR)
(a) Residence. No. (Usual place of abode)
No.
Mass. General Hospital
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Place of Burial or Cremation (City or Town)
RECEIVES
6
Sm
DEC2 01000 ML
1
PLACE OF DEATH
Suffolk (County)
Winthron (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 233
No .
Bay View Rest Home
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran. (if so specify WAR)
(a) Residence. No. (Usual place of abode)
57 Cottage Park Road
St. .
(If nonresident, give city or town and State)
Length of stay: In place of death years 9 months. days. In place of residence
20 years
.months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED single
4I HEREBY CERTIFY,
pily
19 50
to
That
Weg. 9
1950
I last saw healive on 12/91 ... 193.0 , death is said to
have occurred on the date stated above, at 3:30 Am.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Brancho pneumonia
ANTE CEDENT (b) CAUSES
· Generalizadasteria
-
Occupation :
retired clerk
Due To (c)
Celebral Thrombosis
OTHER SIGNIFICANT CONDITIONS
- - -
Major findings:
Of operations.
Date of operation.
Local Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of decease: 200 If so. specify M. D. (Signed) (Address) 26 Waveway Due Date 12/10/ 1950
6
Pine Hill Cemetery W. Bridgewater Place of Burial or Cremation (City or Town)
DATE OF BURIAL Dec. 11.1950
7 NAME OF
FUNERAL DIRECTOR
alfred B.March
ADDRESS 174 Winthron St. Winthrop
Received and filed.
19
DEC 13 1950
(Registrar)
INTERVAL BE- TWEEN ONSET AND DEATH 1 mk.
11 IF STILLBORN, enter that fact here.
12
AGE84
.Years
6
Months
21 Days
If under 24 hours
Hours
Minutes
13 Usual
(Kind of work done during most of working life)
14 Industry
or Business :
Met.Water. Comn.
15 Social Security No. .
none
16 BIRTHPLACE (City)
(State or country)
West Bridgewater Mass.
17 NAME OF
FATHER
Nathan Edson
18 BIRTHPLACE OF
200
FATHER (City)
West Bridgewater
(State or country) Mº88. 19 MAIDEN NAME OF MOTHER Eunice Ryder
20 BIRTHPLACE OF MOTHER (City) West Bridgewater
(State or country) Mass
21 Informant Mrs Charles Crane
(Address) 4 Moore St 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)
Le altre Office 12/11/50
(Official Designation)
(Date of Issue of Permit)
M R-301A -
TRUCTIONS FOR L CERTIFICATE
giving OF DEATH not enter than one e for each (b) and (c)
does not mean of dying, such silure, asthenia. cans the disease. lications which ath.
bid conditions, ving rise to the se (a) stating erlying cause
itions contrib- he death but not the disease or causing death.
'50M (B)-12-49-900722
3 DATE OF DEATH December (Month)
Bay)
1959
(Year)
attended deceased from
female white
10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
10 yrs
3 mos
PARENTS
Registered No.
2 FULL NAME Alice Edson (If deceased is a married, widowed or divorced woman, give also maiden name.)
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 imine- 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 shall exhumne a huinan hody 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 elerk, 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, 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 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 niade 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
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