USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 33
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TWEEN DNSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) prematurity
ANTE Due To CEDENT (b) CAUSES
-
Due To
(c)
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)
(Address) .
M. D. 21 Brew HEate 6/20 2/ 1951
6 Place of Barial of Cremation
City of Town)
DATE OF BURIAL 4 kil 26 19
7 NAME OF
FUNERAL DIRECTOR.
ADDRESS
Received and filed 19
APR2.6.1951
SOM-2-19-25666
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such ilure, asthenia, ans the disease, cations which 1th.
id conditions. ing rise to the se (a) stating rlying cause
itions contrib- e death but not the disease or causing death.
-a 7-158;
2 FULL NAME
(a) Residence. No. .. (Usual place of abode months Length of stay: In place of death. years. 1 hr 32 min
3 DATE OF
DEATH
(ionth)
21 (Day)
51
PARENTS
Nutter
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 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 suchi 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 cxamination 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 clectrical agents or following abortion, or from discascs 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
M R-302 1
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
25m-(b)-11-49-900,475
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 Veteran's Adm.Hospt West Roxbury
Boston
(City or town making return)
39626
Registered No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Winthrop Mass.
w W #1
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
.years ..
3
months
days. In place of residence
59
years
2
months
days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
10a If married, widowed, or divorced 1 en Cahill
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.
Years
5
59
Months
18
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation:
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No ..
16 BIRTHPLACE (CityWinthrop ... Mass. (State or country)
17 NAME OF
FATHER
Walter Belcher
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Winthrop Mass.
19 MAIDEN NAME
OF MOTHER
Amelia Coffin
20 BIRTHPLACE OF
Prince Edward Island
MOTHER (City)
(State or country)
-
21
Informant
( Address)
V A Hospt Records
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
Received and filed
MAY-7 19
1951
(Registrar of City or Town where deceased resided)
No.
2 FULL NAME
Arthur R Belcher
(a) Residence.
No.
30 Wilshire
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Day)
April 21/51
(Month)
(Year)
4 I HEREBY CERTIFY,
Jan.22.
19
51
That I attended deceased
from
to.
April 21
19
51
...
I last saw h .............. alive on
19
...... , death is said to
have occurred on the date stated above. at
1 .; 35An.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
L
Days
Lobar pneumonia R U
L L L-R.L.L.
TO DEATH (a)
TWEEN ONSET
AND DEATH
ANTE
Due To
Carcinoma of the prostate
CEDENT (b)
CAUSES
with diffuse metastases
Yrs
Due To
Mos.
Inanition
(c)
Hydronephrosis and acute
OTHER
pyelonephritis
Mos.
SIGNIFICANT
Major findings:
Of operations.
Date of operation.
Was autopsy performed ?. ,
What test confirmed diagnosis?
Clinical .laboratory
and autopsy findings
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
PARENTS
West Roxbury Massa. 4-21
19 .... 51
JS Guyboski
M. D.
(Address)
6
Winthrop Cem-Winthrop Mass.
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
April 24/51
19
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
calculi of the urinary bladder
Mos.
7 NAME OF
FUNERAL DIRECTOR
J F O'Maley
ADDRESS Winthrop Mass.
.....
DATE FILED
April 25/51
................. .19
18
(write the word)
Bus Driver
Entered Service 3-30-17 Discharged 1-1-19 Seaman U. S.Navy Service No. 111 27 60
RM 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
BOSTON
(City or town making return)
Registered No.
395787
Mass. Memorial Hospital No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
69 Circuit Road
St.
Winthrop
Mass.
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death.
... years.
.. months.
7
days. In place of residence
25.
ars
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
4 I HEREBY CERTIFY,
April 1419 51
to
April 21/5119
That I attended deceased from
I last saw h
imalive on
April 21 19 51
death is said to
have occurred on the date stated above, at
10;35 m.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Pyelonephritis chronic
TWEEN ONSET
AND DEATH
Mos.
11 IF STILLBORN. enter that fact here.
12
AGE
Years
Months.
27
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Clerk
(Kind of work done during most of working life)
14 Industry
or Business:
WoolennCo.
15 Social Security No.
011-16-3845A
16 BIRTHPLACE (City)
(State or country)
Providence R.I.
OTHER
SIGNIFICANT
Arterio sclerosis gener alizeb
CONDITIONS
Yrs
Major findings:
Of operations.
Carcinoma bladder
Date of operation
Was autopsy performed?
What test confirmed diagnosis?
Biopsy
5 Was disease or injury in any way related to occupation of deceased ?. If so. specify.
(Signed) E. T .Rafferty M. P.
Mass em Hospt Date 4-21
(Address)
Winthrop (Cem-Winthrop Mass
DATE OF BURIAL ..
April 24/51
19
7 NAME OF
FUNERAL DIRECTOR
H S Reynolds
ADDRESS
Received and filed MAY 7 1951 19
(Registrar of City or Town where deceased resided)
PARENTS
17 NAME OF
FATHER
Howard H Snow
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Providence R.I.
19 MAIDEN NAME
OF MOTHER
Abbie Boss
20 BIRTHPLACE OF
Newport R. I
G C Snow
.
A TRU
goharles it Jacke
ATTEST:
(Registrar of City or Town where death occurred)
April 25/51
DATE FILED
.19
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 CAUSES
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
25m-(b)-11-49-900.475
3 DATE OF
DEATH
April 21/51
(Month)
(Day)
(Year)
10a If married, widowed, or divorced
Georgie C Young
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
ANTE
Due To
Carcinoma bladder
CEDENT (b)
Due To (c)
Mos.
Place of Burial or Cremation (City or Town)
19 51 MOTHER (City) (State or country)
21 Informagt ........
Winthrop Mass.
82
6
(Was deceased a
U. S. War Veteran.
if so specify WAR)
Howard D Snow
PLACE OF DEATH Suffolk County)
Rever 6/7/8
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. 88
No 142 Pleasant It (Conv. Home)
Daniel Martin 2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death years .. .months.
7 days. In place of residence 30 years .months .days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Widowed
10a If married, widowed, or divorced HUSBAND of Mary Kiley
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
6MM AGE
12 &.S.Years - Months .. ... Days
If under 24 hours
Hours . ... Minutes
13 Usual
Occupation :
Retired
(Kind of work done during most of working life)
14 Industry or Business: Bricklayer
15 Social Security No. ...
012 - 12-6782
16 BIRTHPLACE (City)
Glasgow, Scotland
.
17 NAME OF FATHER Owen Martin
18 BIRTHPLACE OF FATHER (City) (State or country)
Scotland
19 MAIDEN NAME OF MOTHER
Cannot Be Learned
20 BIRTHPLACE OF MOTHER (City) (State or country)
Cannot Be Learned
100M-(D)- 10-48-24656
7 NAME OF FUNERAL DIRECTOR. Paul Buonfiglio ADDRESS 128 Givere St. Rovere
Received and filed .. 19
APR 25 1951
(Registrar)
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Cormany heart disease
Due To
ANTE CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Heart failure
24hrs
Major findings: Of operations. Ivme
Date of operation
Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? 10 If so, specify. Calen
(Signed) 94 Bancaso ReeveDat@mail 24 1951 (Address)
M. D.
malden -
6 Holy Cross com Place of Burial or Cremation (City or Town) DATE OF BURIAL april 25, 1951
21 Informant alfred Holland martin. (Address) Square de Levere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Walter & Bakes (Signature of Agem of Board of Health or other) Healthe Office 4/24/51
(Official Designation) (Date of Issue of Permit)
1
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
amil Month)
23 (Day)
1551 (Year)
4 I HEREBY CERTIFY. Oct.23 50 ...
to ....
That I attended deceased from april 23 1959
I last saw h .alive on april 23 15, death is said to
have occurred on the date stated above, at 12:00p.m.
57 Vane St
St.
f(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) .
Revere mas
(If nonresident, give city or town and State)
No
UCTIONS OR CERTIFICATE
iving F DEATH t enter han one For each ) and (c)
does not mean f dying, such ure, asthenia. 15 the disease, ations which h.
conditions. ng rise to the (a) stating ying cause
ons contrib- death but not e disease or using death.
PARENTS
(State or country)
R-301A 1 Winthrop (City or Town)
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 artny, 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 statenient 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.
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