USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 41
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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 BOSTON
(City or Town)
New England Baptist
[(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.)
(a) Residence. No.
40 Bank
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death
......... years.
months.
22
days. In place of residence.
2 ... years
.months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(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,
April 23 /51
to
That
I
attended deceased from
May 14
51
19
10a If married, widowed, or diwreed jorje M Morrell
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
DISEASE OR CONDITION DIRECTLY LEADING Generalized carcinomatosis
TO DEATH (a)
6 Weeks2
38
ÅGE
Years ....
Months
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :
Draftsman
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Archie D Georg
18 BIRTHPLACE OF
Deery New Hampshire
FATHER (City)
(State or country)
19 MAIDEN NAME
OF MOTHER
Clara LaFamme.
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
Winthrop Cem-Winthrop Mass.
Place of Burial or Cremation (City or Town)
DATE OF BURIAL
May 17/51
19
7 NAME OF
FUNERAL DIRECTOR
F J Crosby
ADDRESS
Boston Mass.
Received and filed
MAY 2-34351
19
(Registrar of City or Town where deceased resided)
4 Mos
CEDENT (b)
CAUSES
right kidney
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Tumor right kidney
Of operations.
Date of operation.
Jan/18/51Was autopsy performed ?...
What test confirmed diagnosis?
Pathological sections
5 Was disease or ipjury in any way related to occupation of deceased?
If so, specify ...
R J Duncan
(Signed)
(Address)
Boston Mass.
Date.
5-14
1951
M.P.
PARENTS
Mrs M M George
21
Informant
(Address)
1
A TRUE COPYMakes
4. nach
ATTEST:
(Registrar of City or Town where death occurred
DATE FILED
May 18/51
BOSTON
(City or town making return)
16077
Registered No.
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 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 WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
25m-(b)-11-49-900,475
No.
Archie George
(Was deceased a
U. S. War Veteran,'
if so specify WAR)
Winthrop Mass.
W W #2
I last saw
.. im .... alive on.
May 14 1.51
death is said to
have occurred on the date stated above, at.
5:25PM
m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
ANTE Due To Renal cell carcinoma
Somersworth N.H.
17 NAME OF
FATHER
6
May 14/51
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION . OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
....
Boston
Entered Service March 22,1941 Discharged Nov. 30,1944 Tech.Sgt. U S Army Service No. 31032541
M R-301 1
PLACE OF DEATH
Winthrop (County)
Suffolk (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Winthrop (City or town making return)
Registered No.
108
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Theodore Rudolph Leonard Johnson 2 FULL NAME.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
81 Main Street
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. 35 years ..
... months.
.days. In place of residence
.35 .years
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR OR RACE
white
10 SINGLE
MARRIEDma Ficheaord)
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY.
That I attended deceased from
-
10a If married, widowed, or divorced
HUSBAND of.
Gerda Olafson
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 42 Years 2 Months.
2.6 Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation :.
self employed
(Kind of work done during most of working life)
14 Industry
or Busines@11 .... Burner .... sales and Service
15 Social Security No ..
025-09-2797
16 BIRTHPLACE (City)
(State or country)
Mass.
Everett
17 NAME OF
FATHERCharles William Johnson
18 BIRTHPLACE OF
FATHER (City)
Gottenburg.
(State or country)
Swed en
5 Was disease or injury in any way related to occupation of deceased? no
Specarthur @ Murray
M. D.
(Signed)
Winthrop Bound Date 15 May 1951
Winthrop
of Healthcemetery, Winthrop
(Clty or Town)
Place of Burial or Cremation
DATE OF BURIAL. May 18, 1951
7 NAME OF
FUNERAL DIRECTOR
alfred B. Marche
ADDRESS
174 Winthrop St, Winthrop
Received and filed
MAY 18 1951
.19
(Registrar)
PARENTS
19 MAIDEN NAME
OF MOTHER
Nanna Christena rahlanda
20 BIRTHPLACE OF
MOTHER (City)
Stockholm
(State or country)
Sweden
21 Informant Mrs Theodore K.L. Johnson (Address) 81 Main Street, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burialor transit permit was issued:
Walter
(Signature of Agent of Board of Health or other)
Thealth Office
5/17/5/
1
(Official Designation)
(Date of Issue of Vermit)
A TRUE COPY ATTEST
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
natural causes
Presumably
ANTE
CEDENT (b)
CAUSES
-
Due To
Coronary
(c)
Occlusion
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation.
Was autopsy performed? no
What test confirmed diagnosis?
SOM IA ). 12 49.900722 -
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 th.
id conditions, ing rise to the se (a) stating Flying cause
tions contrib- e death but not the disease or causing death.
May
(Month)
15 (Day)
1951 (Year)
19
-
to
19
(Give maiden name of wife in full)
I last saw h. alive on.
19 ........ , death is said to
have occurred on the date stated above, at
9:00 A.
.. m.
-
No. 81 Main Street
-
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
(Usual place of abode)
3 DATE OF
DEATH
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 behof 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 als 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 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 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 he 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, See. 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 hody of such a person, he shall forthwith go to the place where the body lies and take charge of the same; General Laws, Chap. 38, Sec. 6.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make somne 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, ete. 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
1
PLACE OF DEATH
Suffolk (County)
TADE
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
(City or town making return)
Registered No. 109
J(If death occurred in a hospital or institution,
St. \ give its NAME instead of street and number)
2 FULL NAME
William S Young
(If deceased is a married, widowed or divorced woman, give also maiden name.)
16 Underhill Street
St.
(If nonresident, give city or town and State)
Length of stay: In place of death .. . years.
months. 1 .days. In place of residence years months. .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
May
(Month)
15
(Day)
1951.
(Year)
4 I HEREBY CERTIFY
Jan 10.
19
1948
May 15
195/
1 last saw
alive on.
May IS 195/ death is said to
have occurred on the date stated above, at 3. 10 INTERVAL BE-
TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.
12
3 1/2 /LAGE
.7.7Years
Months.
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Stereotype
(Kind of work done during most of working life)
2 yrs.
Due To (c)
OTHER
Store in right
CONDITIONS
5 grs.
Major findings:
Of operations.
none
Date of operation.
What test confirmed di
.. Was autopsy performed? clinicalx laboratory
5 Was disease or injury in any way related to occupation of deceased? Lo
3562 Stur
y DIte
Mano
Withcar
Place of Burial or Cremation DATE OF BURIAL May 17
19 51
21
Inforniant
Julia Creedon
(Address) 16 Underhill St. Winthrop, Ma
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial oy transit permit was issued:
Walteras Bakery (Signature of Age of Board of Health or other)
Healthe Office (Official Designation) (Date of Issue of Permit)
15/16/57
A TREL COPY ATTEST
(Registrar)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE (write the word) MARRIED WIDOWED or DIVORCED Widowed
10a If married, widowed, faitofurine Creedon HUSBAND of (Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY
LEA
Cerebral
TO DEATH (a).
Hemorrhage
ANTE CEDENT (b) CAUSES
Due To
Hypertension
14 Industry
or Business:
Newspaper
15 Social Security No.
010-07-4041A
Worcester
16 BIRTHPLACE (City).
(State or country)
Mass
17 NAME OF
FATHER
James Young
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
19 MAIDEN NAME
OF MOTHER
Elizabeth Stewart
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
Hinthrobbut leps2 6
7 NAME OF
FUNERAL DIRECTOR Y
ADDRESS
Winthrop mais
Received and filed
MAY 16 1951
19
504 (A) 12 49.900722
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, ications which ath.
id conditions, ring rise to the se (a) stating rlying cause
itions contrib -- e death but not the disease or causing death.
M R-301 1 Winthrop (City or Town)
No.
Winthrop Community Hospital
CERTIFICATE OF DEATH
Į (Was deceased a U. S. War Veteran, [ if so specify WAR>
(a) Residence. No. (Usual place of abode)
40
That I attended deceased from
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 leceased, 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 hiscase 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 Er officer an 1 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 als certify in such certificate both the primary and the secondary or iminc- 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 leemel to have taken place between February fourteenth, eighteen hundred and pinety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventecn. 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 pernuits, 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 perinit. 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 cxaminer 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 issuc 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.
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