Town of Winthrop : Record of Deaths 1951, Part 27

Author: Winthrop (Mass.)
Publication date: 1951
Publisher:
Number of Pages: 614

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 27

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

Registered No.

2 FULL NAME

(If deceased is a married, widowed or divorced woman, give also maiden name.) 46 Enfield Ord,

(If nonresident, give city or town and State)

That I

attended deceased from

march 27, 195%, death is said to

have occurred on the date stated above, at

DISEASE OR CONDITION

DIRECTLY L

TO DEATH (a)

Carmona Fatemeh

PARENTS

D .Jemens Stoffer

Breedft Ed Dat Man. 37

. 195/

R-301A 1

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 clisease 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 arniy, 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, 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 persons as are supposed to have died by violence, or hy 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.

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 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

PLACE OF DEATH

Suffolk (County)

Winthrop

(City or Town)

The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD

(City or town making return)

f(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) No.

2 FULL NAME.

Carolina ( Anderson) Lindberg

(Was deceased a

U. S. War Veteran,

if so specify WAR)

(If deceased is a married, widowed or divorced woman, give also maiden name.) 921 Shirley Street

St.

(If nonresident, give city or town and State)

Length of stay: In place of death. years ..

months. 3 days.

In place of residence

45 years.

... months.

.days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

March 28,1951

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY,

That I attended deceased from

Mar.7 19.

to ..

Mar.28

195.1

I last saw

alive on

Mar.27

. 19.5.1 death is said to

have occurred on the date stated above, at ..

3:15a.m.

INTERVAL BE- TWEEN ONSET AND DEATH

DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a). accident

4 days

ANTE CEDENT (b) CAUSES

Due To antes acceso . (c)

generalized

OTHER SIGNIFICANT CONDITIONS

Major findings:

Of operations

Date of operation.

Was autopsy performed?

What test confirmed diagnosis?

5 Was disease or injury in any way related to occupation of deceased? If so, specify (Signed) Toper laregione M. D.

(Address) 22 Wcaleytan a Date 3/28

.19 37

6 winthrop

Place of Burial or Cremation

DATE OF BURIAL.

7 NAME OF

FUNERAL DIRECTORI.

coming mais

Received and filed

APR 2 1951

(Registrar)

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

9 COLOR OR RACE

10 SINGLE

(write the word)

Female

White

MARRIED

WIDOWED

or DIVORCED Married

10a If married, widowed, ondiversedes A Lindberg HUSBAND of.

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

12 AGE 17 Years 9 Months 25 Days

If under 24 hours

Hours.

Minutes

13 Usual

Housewife

Occupation:

(Kind of work done during most of working life)

14 Industry

Own home

or Business:

15 Social Security No.

None

16 BIRTHPLACE (City) (State or country) Sweeden

Andersa.

17 NAME OF

FATHER

Unable to obtain

PARENTS

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Sweeden

19 MAIDEN NAME

OF MOTHER

Unable to obtain

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Sweeden

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

Walter . Bakker (Signatkire of Alent of Board &Health or other) Health Office (Official Designation) (Date of Issue of Permits

3/30/5/

A IRCE COPY ATTEST

TIONS TIFICATE ing DEATH enter n one each and (c)

not mean ying, such , asthenia, he disease. ms which

onditions, rise to the 1) stating 1g cause

s contrib- th but not disease or ing death.

5OM (A). 12 49.900722

Saward Sahunolds

ADDRESS

0000

Winthrop

(City or Town)

March 30

19 52

Charles A Lindberg

Informant

(Address)

921 Shirley St. Winthrop

CERTIFICATE OF DEATH

Registered No.

Winthrop Community Hospital

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

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 inember of the family of the cleceased, 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 br 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 of marine corps of the United States in any way 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, 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 cnough 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.

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,

Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.

SPACE FOR ADDITIONAL INFORMATION

DATE OF ENTERING MILITARY SERVICE

DATE OF DISCHARGE RANK, RATING

ORGANIZATION AND OUTFIT

SERVICE NUMBER

PLACE OF DEATH

Suffolk (County)

R-301 1 Winthrop (City or Town)

The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH

(City or town making return)

Registered No.

291 Winthrop Street No.

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

2 FULL NAME.

Alton Hooper Evitts

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

(a) Residence. No. 291 Winthrop Street

St.

(If nonresident, give city or town and State)

Length of stay: In place of death. .15 years.

months. days. In place of residence years .. months days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

3 DATE OF

DEATH

March

(Month)

(Day)

1951 (Year)

8 SEX Male

9 COLOR OR RACE

White

10 SINGLE

(write the word)

MARRIED

WIDOWED

of DIVORCED Married

4 I HEREBY CERTIFY.

19.

1951

10a If married, widored,atdiressd Dunham

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGE

.Years

Months

Days

If under 24 hours

Hours.

Minutes

13 Usual

Occupation :

Clerk

(Kind of work done during most of working life)

14 Industry

or Business:

Production(General electri(

15 Social Security No.

027-07-9502

Salem

16 BIRTHPLACE (City)

(State or country)

Mass.

17 NAME OF

FATHER

John Evitts

18 BIRTHPLACE OF

Denton

FATHER (City)

(State or country)

Maryland

19 MAIDEN NAME

Unable to obtain

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Boston Mass

6 finthron

Place of Burial or Cremation

April 2

7 NAME OF

FUNERAL DIRECTOR

Saward S Reynold

ADDRESS Winchal mal.

Received and filed.

APR 4

1951

(Signature pf Agf/+ G Board of Healthton other)

H.O.

(Official Designation)

(Date of Issue of Permit)

CTIONS R RTIFICATE

ving DEATH enter an one r each and (c)

es not mean dying. such e, asthenia, the disease, ions which

conditions, rise to the (a) stating ing cause

ns contrib- ath but not disease or sing death.

SOM (A). 12.49.900722

ANTE

CEDENT (b)

CAUSES

Due To · Coronary Occlusion Hours

Due To

(c)

OTHER

SIGNIFICANT

CONDITIONS

Major findings:

Of operations

mone

Date of operation

Was autopsy performed 0

What test confirmed diagnosis ?.

clinical

5 Was disease or injury in any way related to occupation of deceased' (en

If so, specify

(Signed)

(Address) Winthrop Mass

c. F.Mahoney, M. D.

Date 30 March 19.51

inthron

(City or Town)

DATE OF BURIAL .. ..

Florence Evitts

Informant

(Address)

291 Winthrop St. Winthrop

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

watter & Bater

april 2/ 5/

(Registrar)

A TRUE. COPY ATTEST

That I attended deceased from

I last saw him? alive on

15March 1951, death is said to

have occurred on the date stated above, at 11:30 p.m.

INTERVAL BE- TWEEN ONSET AKO DEATH

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH (a)

Sudden Heart Failure

(Was deceased a

U. S. War Veteran,

if so specify WAR)

(Usual place of abode)

PARENTS

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 effe. t. 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 hundre 1 and fourteen, the word "war" shall include the China rehef 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 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 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

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Town of Winthrop : Record of Deaths 1951, Part 27

Author: Winthrop (Mass.) Publication date: 1951 Publisher: Number of Pages: 614

Author: Winthrop (Mass.)
Publication date: 1951
Publisher:
Number of Pages: 614