USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1950 > Part 81
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Dec. 18/50
(Month)
(Day)
(Year)
8 SEX
F
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
4 I HEREBY CERTIFY,
That I attended deceased
from
50
Dec. 18
19
death is said to
have occurred on the date stated above, at
8:54A
.m.
INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
50
AGE
Years
.Months.
.Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
Cashier
14 Industry
or Business:
Bank Cafeteria
15 Social Security No ..
023-20-3295
16 BIRTHPLACE (CitCharlestown ... Mass. (State or country)
17 NAME OF
FATHER
James H Hanton
18 BIRTHPLACE Boston Mass.
FATHER (City).
(State or country)
19 MAIDEN NAMElizabeth Carrigan OF MOTHER
20 BIRTHPLACE OF
MOTHER (City) anchester N.H.
(State or country)
21
Informant
(Address)
J J Magee
DATE OF BURIAL.
Dec. 21/50
19
7 NAME OF
FUNERAL DIRECTOR
East Boston Mass
ADDRESS
Received and filed. 19
(Registrar of City or Town where deceased resided)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
James J Magee
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Malignant lymphoma
1 Yr
-Plus
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
None
Major findings:
Of operations.
Date of operation
Was autopsy performed?
No
What test confirmed diagnosis ?.
Clinical
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
CL Clay
(Signed).
(Address)
Mass. General Hospate 12-18 1950
Winthrop Cem-Winthrop Mass.
6
Place of Burial or Cremation (City or Town)
C H Treanor
A TRUE COPY
4
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Dec/22/50
.19
...........
PARENTS
25m-(b)-11-49-900,475
No.
Mass. General Hospital
(Was deceased a
U. S. War Veteran,
if so specify WAR).
Dec ..... 1.2 ..... ,
19.
5.0
to.
I last saw h .... er .... alive on
Dec. 18 19.50
(Kind of work done during most of working life)
RECEIVEA
12
11
3
S
5
6
JAN-C1951 MM :
M R-303 A 1
N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of
of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
50m-(g)-10-48-24658
DATE OF BURIAL .. Skc 21 scale
8 NAME OF FUNERAL DIRECTOR
ADDRESS. 54 Pleasant el
Received and filed.
DEC 28 1950
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
Vale
10 COLOR OF RACE White
11 SINGLE MARRIED WIDOWED or DIVORCE
11a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13 45
AGE
Years
Months.
... .. . Days
If under 24 hours Hours. .... Minutes
14 Usual
Occupation :
15 Industry
or Business:
(Kind of work done during most of working life) Semanal.
16 Social Security No.
17 BIRTHPLACE (City)
(State or country)
18 NAME OF FATHER
19 BIRTHPLACE OF FATHER (City) ...... (State or country)
Sichand
Mary Kakaoum the land
Informan (Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Matthew J. Mullaney
{ ] (Signature of Agent of Board of Health or other)
24296
(Official Designation)
(Date of Issue of Permit)
1
December 19, 1950 (Day) (Year)
(Month)
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.) .
asphyxia due to inhalation Carl moxide
marly suicidal
5 Accident, suicide, or homicide (specify).
duicule
Date and hour of injury ...
19 1950
Where did
Injury occur?
Winthrop man
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place? Ho
(Specify type of place)
Manner of Injury Inhalat
of illuminatingas
Nature of
Injury
asph
While at work?
Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased?
(Signed)
.. , M. D.
7 Place of Burial, or Cremation
to 2/19.1956 (City or Town)
PARENTS
20 MAIDEN NAME OF MOTHER
21 BIRTHPLACE OF MOTHER (City) (State or country)
22
f(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
William Mc Donough 2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
63 Fremant 1/
St.
Winthrop
(If nonresident, give city or town and State)
PE
.months
Length of stay: In place of death. .years .. months .. In place of residence. ... years.
30 days.
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 its Agent.
Registered No.
215.
PLACE OF DEATH No. 63
Suffolk (County) Winthrop (City or Town
Ist.
PHYSICIAN - IMPORTANT j (Was deceased a N. S. War Veteran. if so specify WAR)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF DEATH
(write the word)
BUSTUR
19
ity) Gala Man
(How did injury occur?)
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 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
·50M (B)-12-49-900722
×
PLACE OF DEATH
Suffolk (County)
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. 246
Registered No.
Winthrop Community Hospital, 40 LincolnIf death occurred in a hospital or institution give Its NAME instead of street and number)
2 FULL NAME Alice Burns Doherty
(If deceased is a married, widowed or divorced woman, give also maiden name.) 47 Loring Road, Winthrop, Mass St.
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death
0 years 0 months 23
days. In place of residence
10
years
months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX F
9 COLOR OR RACE
White
10 SINGLE
/ ++++ the word)
MARRIED
WIDOWED
or DIVORCED
Divorced
4 I HEREBY CERTIFY.
That
I attended deceased from
har. 24, 1950, to.
Dec. 20
...
1950
Dee- 19
... 1950, death is said to
have occurred on the date stated above, at
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a)
Carcinomatorio
ANTE
CEDENT (b)
CAUSES
Carcinoma of Items
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
anemia,
6 mas.
Major findings:
Of operations.
Carcinoma of Ultimes witte hetastins
Date of operation
June 1949 Q
Was autopsy performed?
What test confirmed diagnosis ?.
Pathological
5 Was disease or injury in any way related to occupation of deceased? To
(Signed)
Charles Liberque
, M. D.
(Address) 26 Wane Way Que Date 12/20/1950
Place of Burial or Cremation
DATE OF BURIAL
Dec 22
1950
7 NAME OF
FUNERAL DIRECTOR
os Puedenick & magnate
ADDRESS East Boston
Received and filed
DEC 23 1950
19
(Registrar)
10a If married, widowed, or divorced HUSBAND of ... XXXXXXXXXXXXXXXXXXXX.
(Give maiden name of wife in full)
(or) WIFE of
Charles R. Doherty
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
6.0Years
O Months .
3 Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
at Home
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No. . 012-03-7278
16 BIRTHPLACE (City)
(State or country)
Vermont
17 NAME OF FATHER John Burns
18 BIRTHPLACE OF
FATHER (City)
Bolton
(State or country)
Vermont
19 MAIDEN NAME OF MOTHER . ary Purcell
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Vermont
Vergennes
Charles R Doherty for
21 Informant (Address) 47 Leaving Road Winthu
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Walter & Bakery (Signature of Agent of Board of Health or other)
realite Officer
12/21/50
X
(Official Designation) (Date of Issue of Permit)
STRUCTIONS FOR AL CERTIFICATE
In giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean de of dying, such failure, asthenia. means the disease, plications which death.
orbid conditions. giving rise to the ause (a) stating derlying cause
nditions contrib. the death but not to the disease or n causing death.
PARENTS
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, none if so specify WAR)
(If nonresident, give city or town and State)
3 DATE OF
DEATH
Dec.
(Month)
20 (Day)
1950 (Year)
RM R-301A 1 Winthrop (City or Town)
Kindge are amely.
leambudge
(City or Townd
Burlington
I last saw h Q.alive on
7:30 A. m.
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 are, 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 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, 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 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 of 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 ahortion, 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.
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 occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work dore 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 of Town) 466 Pleasant Street
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.
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