USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 6
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE .
RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
X
PLACE OF DEATH
MIDDLESEX
(County)
WATERTOWN
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH 119 PALFREY ST.
WATERTOWN
(City or town making return)
Registered No.
4
15
JEANETTE CONVALESCENT HOME 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.)
497A SHIRLEY
WINTHROP St
(If nonresident, give city or town and State)
Length of stay: In place of death
.. years.
3
.months.
.days. In place of residence.
.years.
months
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
JANUARY 14, 1951
(Month)
(Day)
(Year)
8 SEX
MALE
9 COLOR OR RACE
WHITE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
VID.
4 I HEREBY CERTIFY.
SEPT. 12
50
JAN. 14
That I
attended deceased from
51
19
HUSBAND of
(Give maiden name of wife in full)
I last saw h
alive on
JAN. 69
19 ..
5death is said to
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
72
AGE
Years
Months.
Days
If under 24 hours
Hours .....
.. Minutes
13 Usual
Occupation :
SUPERINTENDENT
14 Industry
or Business:
OFFICE BUILDING
15 Social Security No.
022-65-2865A
16 BIRTHPLACE (City).
(State or country)
GASPORT HANTS, ENGLAND
17 NAME OF
FATHER
JOHN RAWLINGS
18 BIRTHPLACE OF
FATHER (City).
(State or country)
GASPORT HANTS, ENGLAND
19 MAIDEN NAME
OF MOTHER
CAROLINE SCOTT
.
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
ENGLAND
UT. PLEASANT CEMETERY, ARLINGTON, MASS. 6
Place of Burial or Cremation (City or Town)
DATE OF BURIAL 19
7 NAME OF FUNERAL DIRECTOR. D. M. GRANNAN & SON
ADDRESS
378 MASS. AVE., ARLINGTON, MASS.
Received and filed 19
JAN 10 1051
(Registrar of City or Town where deceased resided)
21 MRS. LU. FRASER (DAUGHTER).
Informant (Address) RINDGE AVE., CAMBRIDGE, MASS.
A TRUE COPY
Luong B Wellenan
ATTEST:
(Reg. ray y. City or Town where death occurred)
DATE FILED JAN. 18,
...... ........... 19 51
y
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
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
25m-(b)-11-49-900,475
(Address).
(Signed)
CAMBRIDGE, MASS.
Date
1/14
M_ 10 51
PARENTS
5 Was disease or injury in any way related to occupation of deceased? If so, specifyCHARLES"F" WALCOTT
NO
Date of operation.
.Was autopsy performed?
NO
What test confirmed diagnosis?
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a).
AORTIC STENOSIS
INSUFFICIENCY
10 YRS
ANTE
Due To
ARTERIOSCLEROSIS
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
CEREBRAL ARTERIOSCLEROSIS
Major findings:
Of operations ..
19
to
have occurred on the date stated above, at.
3:20 P.
.m.
10a If married, widowed, or divorced
MARY R. HURLEY (RAWLINGS)
(write the word)
(a) Residence. No. (Usual place of abode)
4
(Was deceased a
U. S. War Veteran,
if so specify WAR)
NONE
HENRY V. RAWLINGS
M R-302 1
JANUARY 17, 5
(Kind of work done during most of working life)
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 CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
16
Registered No.
[(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME. JAMES
C. Frost
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. . 1024 Bennington St. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death
months. 18 days. In place of residence 15years
.months
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
malE
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED Single
10a If married, widowed, or divorced
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
43
2
.Months
2Days
If under 24 hours
Hours .. . Minutes
Occupation :
13 Usual
Overseer
(Kind of work done during most of working life)
14 Industry
or Business:
Maverick Mills
15 Social Security No.
024-07-2203.
16 BIRTHPLACE (City)
(State or country)
Mass.
Somerset
17 NAME OF
FATHER
Harrison Frost
18 BIRTHPLACE OF
Bowdoinham
FATHER (City) (State or country)
Maine
19 MAIDEN NAME OF MOTHER Jennie Orvis
20 BIRTHPLACE OF
MOTHIER (City)
IR . I (State or country)
David Frost, brother
I HEREBY CERTIFY that a satisfactory standard certif ate of death was filed with me BEFORE the burial or tragsit permit was issued: Mass. Walter & Baker (Sunature of Agent of Board of Health or other Thealite Officer
1/16/51
(Official Designation) (Date of Issue of Permn)
7
M R-301A 1
TRUCTIONS FOR L CERTIFICATE
giving : OF DEATH not enter e than one e for each (b) and (c)
s does not mean of dying, such ailure, asthenia. eans the disease, lications which ath.
bid conditions. iting rise to the use (a) stating erlying cause
ditions contrib- he death but not the disease or causing death.
Major findings: Of operations
Date of operation. 1- Was autopsy performed?
What test confirmed diagnosis?
10
5 Was disease or injury in any way related to occupation of deceased? If so, specify .... (Signed) (Address) Gio téétat0
, M. D. 1937
Pocasset Hill 6
Place of Burial or Cremation DATE OF BURIAL.
Villaden Tiverton (City or Town) Jan. 18 1951
7 NAME OF FUNERAL DIRECTOR William S Hathaway ADDRESS 1813 Robeson St. Fall River
Received and filed 19
JAN 2.2 1951
(Registrar)
6THG
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Due To Urenfica
ANTE CEDENT (b) CAUSES
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Dalavorain Felecia
TWEEN ONSET AND DEATH
have occurred on the date stated above, at / 2:51 m.
INTERVAL BE-
to
1/1/5, 1951, death is said to
19
I last saw h Incalive on
That, I attended deceased
1951
(Year)
4 I HEREBY CERTIFY,
from 0671 10.50
JANUARY (Month)
15 (Day)
Winthrop Community Hospital
No.
Boston 2/10/01
·50M (B). 12.49-900722
21 Informant (Address) 965 Prospect St. Somerset
Somerset Mass.
PARENTS
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, [ if so specify WAR)
St.
East Boston
(write the word)
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 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 effeet, 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 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 abortion, or fromn 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, See. 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 + hr 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 domestie service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING. ORGANIZATION AND OUTFIT SERVICE NUMBER
M R-303-A
so that it may be properly classified under the International Classification of Causes of Death. See reverse side for should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF DEATH in plain terms, If deceased was a U. S. War Veteran. G. L. Chap. 46, Section 10, requires physicians to insert a recital to that offoot extracts from the laws relative to the return of certificates of death.
PLACE OF DEATH
Sulloll (County ) Wüchrib (City or Town) No. 104 Highland ave
The Commonforalth 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.
17
St. { {If death occurred in a hospital or institution, ( give its NAME instead of street and number)
2 FULL NAME
Margaret
az
Wir Dwald
(If deceased is @married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
115 Hermer St. Mütterop
(Usual place of abode)
Length of stay: In hospital or Institution
( Before death)
( Specify whether)
years
Lmonths
days.
In this community
yra.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE|
5 SINGLE
(write the word)
Female
W ite
MARRIED
WIDOWED
or DIVORCÉarried
5a If married, widowed, or divorced HUSBAND of
(or) WIFE of
Joseph
(Give maiden name of wits in gill)
(Husband's name in full)
6 Age of husband or wife If allve 78
years
7 IF STILLBORN, enter that faot here.
8
AGE.O
Years
Months
Days
If less than 1 day
.. Hours.
.Minutes
Usual
9 Occupation :
Housewife
Industry
10 or Business :
Own ..... Ho.me
11 Soolal Security No ...
12 BIRTHPLACE (City)
(State or country)
Newfoundland
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country) Newfoundland
15 MAIDEN NAME
OF MOTHER
Alice Hanrahan
16 BIRTHPLACE OF
MOTHER (City)
( State or country)
Newfoundland
17 Joseph
MacDonald
Informant ..
( Address)
115 Hermon St
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the bullet or transit permit was Issued: Walter At. Baller
(Signature of Agent of Board of Health or other)
11/8/57
.... (Official Designation) (Date of Issue of Permit) ¿
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Jan
17-1951
(Month)
(Day)
(Year)
19 | 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 waa involved, state fully,) Hypertensie Nicht Viereck;
deduna Lungs:
Recut Fracture Left Tercer
20 Aooldent, sulolde, or homlolde (specify)
accidental
Date of ooourrenoe ...
bur Oct. 15, 19:50
Where did
Injury ooour?
(City 'or town and State)
Did Injury ooour In or about homs, on farm, In Industrial place, or In publie
place ?
(Specify type of place)
Injury
Nature of
tags OCT. +30; 1950
Injury
While at work ?
-
Was there an autopsy ?.
no
21 Was disease or Injury In any way related to ocoupation of deosased ?
If so, speolfy
Hat Trickler
M. D.
(Signed)
(Address)
1951
22
Winthrop
Winthrop
Place of Burlal, Cremation or Removal.
(City or Town)
Relation, if any
DATE OF BURIAL
Jan
20
1951
19
23 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Reoelved and filed ...
19
YAN " 2 2 1251
(Registrar)
PHYSICIAN-IMPORTANT
(Was deceased a
U. S. War Veteran,
If so speolfy WAR)
St.
(If nonresident, give city or town and State)
40
50m. (:)-1.45-15510
13 NAME OF
FATHER
Cannot be learned
Manner
af ell accidentally at per line
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 whoin he lias attended during his last illuesa, at the request of an undertaker or other authorized person or of any member of the family of the lecrased, furnish for registration a standard certificate of death, stating to the best of his knowledge and bellef the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where saine was contracted, the duration of his laat illness, when last seen alive by the pliysician or officer and the date of his death ... Gen. Lawa, Chap. 16, Sec. 9.
A physlelan or officer furnishing & certificate of death an required by the preceding section or by section forty-five of chapter one hundred and four- tecu, shall, If the deceased, to the best of his knowledge and bellef, aerved in the army, wavy 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, specl- fying the war, and shall also certify In such certificate both the primary and the secondary or immediate cause of death as nearly as he can atate the same. For neglect to comply with sny provision of this section, such physician or officer shall forfeit ten dollars. For the purposes of thia aec- tlon sud of sections forty-Ave, forty-six and forty-seven of .said chapter one hundred aud fourteen, the word "war" shall include the ('hina relief ex- pedition and the l'hilippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eiglit and July fourth, nineteen hundred and two, and the Mexi- can bonler service of nineteen hundred and aixteen 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 haa not been buried, until he haa received a perinlt froin the board of health, or its agent appoluted 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 anotlier, or from one grave or tomb other than the receiving tomb to another in the same cenietery, until be haa received a permit from the board of health or Its agent aforesald or from the clerk of the town where the body Is buried. No such perunit shall be lasued until there ahall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written atatenrent containing the facts required by law to be returned and recorded, which ahall be accompanied, in case of an original interment, by a satisfactory certificate of the attending physician, if any, as requireil by law, or In lieu thereof a certificate as hereinafter provided. If there is no attending physician, or If, for sufficlent reasons, his certificate cannot be obtained early enough for the purpose, or Is Insufficient, a phyai- cian who is a member of the board of health, or employed by it or by the selectmen for the purpose, sliall upon application make the certificate re- quired of the attewuling physician, If death la caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previonaly interred, from one town to an- other within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided aud in the pos- session of the undertaker desiring to make such removal ahall constitute a permit for such removal; provided, that such body shall be returned to the town from which It was removed within thirty-aix houra after such re- moval, unlesa 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-xix, that the deceased served in the army, navy or marine corps of the United States in any war in which
it has heen 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 aml transmit it to the clerk of the town for regis- tration. 'I'Ite person to whom the permit ls so given and the physician cet- tifying the cause of death altall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manter or cause of the death, which the clerk or registrar may ro- quire .- Chap. 114, Sec. 15, G. L., (Tercentenary Edition).
No undertaker or other person shall bury a human body or the ashes thereof which have been brought Into the commonwealth until he has re- ceived 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 per- son appointed to have the care of the cemetery or burial ground in which the jutermeut is made. .. . Chap. 114, Sec. 46, G. L., (Tercentenary Edi- tion ).
Medical examinera 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 hla county the body of such a person, lie shall forthwith go to the place where the body lies and take charge of the same; ...- General Laws, Chap. 3S, Sec. 6.
.. lle shall in all cases certify to the town clerk or registrar in the place where the deceased died his name and residence, if knowu; otherwise a description aa full as may be, with the cause and manner of death .- General Lawa, Chap. 38, Sec. 7.
... The medical examiner certifles the cause and manner of death to the hest of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calla for the observance of the following rulea of practice :
(1) Attending physicians will certify to such desths only as those of persons to whom they have given bedside care during a last illnesa from disease unrelated to any forin of injury.
(2) Board of Health physicians will certify to such deaths only an those of persons who, though disabled by recognized disease uurelated to any form of injury, have died without recent inedical attendance or whose phyal- ciau ia absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably due to Injury. . These include not only deaths caused directly or in- directly by traumatisin (including resulting septicemia), and by the action of chenrical (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 persona not disabled by recognized disease, and those of persons found dead.
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