Town of Winthrop : Record of Deaths 1951, Part 71

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1951 > Part 71


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R-302


1


PLACE OF DEATH


Middlesex


(County)


Reading


(City or Town)


93 Walnut Street


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


Reading


(City or town making return)


Registered No.


196


(If death occurred in a hospital or institution, St. give ite NAME instead of atreet and number)


2 FULL NAME


Grace Lydia (Sherman) Bliss


(If deceased ie a married, widowed or divorced woman, give aleo maiden name.)


(If U. S.


speolfy WAR)


(a) Residenoe. No.


219 Court Rd.


St.


Winthrop,


Mass


(Usual place of abode)


(If nonresident, give city or town and State)


Length of stay : In hospital or Institution.


(Before death)


(Specify whether)


years


In this community


40 yre.


moe.


days.


PERSONAL AND STATISTICAL PARTICULARS


MEDICAL CERTIFICATE OF DEATH


3 SEX


Female


4 COLOR OR RACE|


White


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED Widow


5a If married, widowed, or divoroed


HUSBAND of


(or) WIFE of


Arthur


(Give maides pamg of wife in full)


(Hueband'a name in full)


6 Age of husband or wife If allve years


7 IF STILLBORN, enter that faot here.


8


AGE.


76 Years 10 Months


6


.. Days


If less than 1 day


.Hours .......


.Minutes


Usual


9 Ocoupation :


Housewife


Industry


10 or Business:


Own home


11 Soolal Security No.


none


12 BIRTHPLACE (City)


(State or country)


Maine


Other conditions


(Include pregnancy within 3 months of death)


Phyelcian


Major findings :


Of operations.


none


Date of


charged sta- tietically.


Of autopsy


Blood, Uring, Frites


for


What test confirmed diagnosis ?...


20 Was disease or injury In any way related to occupation of deceased ?..... O


if so, speolfy.


John F. Collins


(Signed)


(Address)


Revere , Mass


Det Sept. 7, 19.51-


21 PLACE OF BURIAL,


CREMATION OR REMOVAL.


Winthrop


Winthrop


(Cemetery)


(City or Towp)


51


19


A TRUE COPY.


ATTEST :


Bord It. Stuart


(Registrar of city os town where destb-occurred)


DATE FILED


September


7th


19 51.


18 DATE OF


DEATH


Sept.6,


1951


(Month)


(Day)


(Year)


49


19- I HEREBY CERTIFY,


Nov. 29


19.


to


That i attended deocased from


Sept. 6


I last saw h.


er ...... alive on


Sept. 2, , 1951


death is sald to


have occurred on the date stated above, at 10:30P


m.


Immedlate oause


Hypertensive


Duration


Heart Disease


years


Due to.


Hypertension


Due to.


Diabetes


Mellitus


...


over


4


"years


over


4


13 NAME OF


FATHER


Judson A. Sherman


PARENTS


14 BIRTHPLACE OF


FATHER (City)


Hope


(State or country)


Maine


15 MAIDEN NAME


OF MOTHER


Helen S.Annis


16 BIRTHPLACE OF


MOTHER (City)


Appleton


(State or country)


Maine


17 Cynthia R Gushee Relation, if any


Informant


(Address)


131 E 38th St. New"


York City


22 NAME OF


Howard S.Reynolds


FUNERAL DIRECTOR


ADDRESS


.Winthrop., Mas.s ..


Reoelved and filed


SEP 12 19


19


(Registrar of City or Town where deceased resided)


50m-(b)-6.44-14607


Appleton


Underltne the cauee to which death should be


M. D


DATE OF BURIAL


Sept.


10,


resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)


No.


Rest Home 1


1


months


days.


SEP 12 1951


e


n


PLACE OF DEATH


+ Suffolk (County) Matick 10/9/01


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.


197


A R-301 1 Winthrop (City or Town)


No.


Winthrop Community Hospital


f(If death occurred in a hospital or institution.


St. Į give its NAME instead of street and number)


Helma Mattson (Rickter) 2 FULL NAME.


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


(a) Residence. No. 169 North Main St.


St.


Natick


(Usual place of abode)


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


months. 15


55


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


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


Agat


7


1951


(Month)


(Day)


(Year)


4 I HEREBY CERTIFY,


aug 23


51


to ...


Sept 7


51


51.


19


death is said to


have occurred on the date stated above, at.


6.308. m.


DISEASE OR CONDITION


DIRECTLY


TO DEATH (a)


Cenchal


denverhage


ANTE


Due To


generalizado


CEDENT (b)


CAUSES


arterischio


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)


gyne gateso


M. D.


(Address) 6.2+ 6pm


On Date Rent 7


195%


6 .Dell Park Cemetery


Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


September 10,


51


7 NAME OF


FUNERAL DIRECTOR ..


Burge A. Mitchell


ADDRESS


52 Pond St., Natick


Received and filed


SEP 14 1951


19


(Registrar)


?


14 Industry or Business:


15 Social Security No.


16 BIRTHPLACE (City).


(State or country)


Sweden


17 NAME OF FATHER Paul Rickter


18 BIRTHPLACE OF


FATHER (City)


Helsingborg


(State or country)


Sweden


19 MAIDEN NAME


OF MOTHER


Asserina (can't be Learn


20 BIRTHPLACE OF


MOTHER (City)


Helsingborg


(State or country)


Sweden


21 InformanMrs Henry Nelson (Address) Everett St., Natick, Mass.


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


Walter IBaker


4.O.


(Signature of Agent of Board of Health of other) Sept. 2851 (Date of Issue of Permit)


(Official Designation)


A TRUL COPY ATTE T


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


female


white


9 COLOR OR RACE


10 SINGLE


(write the word)


MARRIED Widowed


WIDOWED


or DIVORCED


10a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of.


Matthias Mattson


(Husband's name in full)


INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.


15 days


77


12


AGE


Years


4


Months


25Days


If under 24 hours


Hours.


Minutes


13 Usual


Occupation:


housewife


(Kind of work done during most of working life)


Helsingborg


PARENTS


SOM (A ) 12 49 900722


UCTIONS FOR CERTIFICATE iving OF DEATH t enter than one for each b) and (c)


ves not mean f dying, such ure, asthenia ns the disease, ations which h.


d conditions. ng rise to the (a) stating lying cause


ions contrib- death but not he disease or ausing death.


(Was deceased a


U. S. War Veteran,


if so specify WAR)


(If nonresident, give city or town and State)


I last saw h


alive on.


i


Apt)


That I attended deceased from|


Natick


-


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 chsease 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 sertion 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 t , that effect, specifying the war, and shall also 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 relief expedition and the Philippine insurrection, which shall, for said purposes, b 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 niade 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.


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 ohservance 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 deathsonly 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 deatlı.


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


A R-301 1


PLACE OF DEATH


Suffol k (County)


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. 198


Winthrop Community Hospital


J(If death occurred in a hospital or institution,


St. [ give its NAME instead of street and number)


Arthur ES Smith Smith Arthur ... E ..... Smith ! (Was deceased a


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


U. S. War Veteran,


if so specify WAR)


.


(If nonresident, give city or town and State)


Length of stay: In place of death. years.


10


months. days. In place of residence 0 .years. .. months. days.


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Male


9 COLOR OR RACE


White


10 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED Married


4 I HEREBY CERTIFY.


That I attended deceased from


Weg 28.


19.57


to.


I last gaw h was alive on. Syst 7, 1951, death is said to


have occurred on the date stated above, at 2:30A.m.


INTERVAL BE.


TWEEM ONSET AND DEATH


11 IF STILLBORN, enter that fact here.


12


69 9


Months


27


Days


-


If under 24 hours


.Hours. ...


.Minutes


13 Usual


Occupation:


Gardener


(Kind of work done during most of working life)


14 Industry


or Business:


Private homes


15 Social Security No.


None


16 BIRTHPLACE (City)


(State or country)


Mass


Lawerence


17 NAME OF FATHER Fred H Smith


PARENTS


18 BIRTHPLACE OF


Lowell


FATHER (City) (State or country) Mass


19 MAIDEN NAME


OF MOTHER


Grace Margerison


5 Was disease or injury in any way related to occupation of deceased 200


If so, specify .


M. D.


20 BIRTHPLACE OR


(Signed)


(Address) 26 Wwwcry Que, Date 4/7/


19.5%


MOTHER (City)


Lakeport


(State or country)


New Hampshire


6 Winthrop Place of Burial or Cremation (City or Town)


DATE OF BURIAL ..


19.51


Laurard Sayynolds


ADDRESS


SEP 14 1951


Received and filed


19


(Registrar)


IRUL COPY AHEY


Sept 7 1951 (Year)


(Month)


(Day)


195%.


10a If married, widowed, or divorced HUSBAND of


(Give maiden name of wife in full)


(or) WIFE of


Grace G Pestell


(Husband's name in full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH


(a) canary


Thisbasis


tembral Humorlige


ANTE CEDENT (b) CAUSES


1yr .


Due To (c)


OTHER SIGNIFICANT CONDITIONS


more


Major findings: Of operations.


Date of operation.


Was autopsy performed ?.


What test confirmed diagno


Clinical


Winthrop


Sept


10


21 Grace Smith


Informant (Address) 73 Crystal Cove Ave.


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


(Signature of Agent fercard of Health or other)


H.r.


(Official Designation)


Sept.


(Date of Issue of Permit)


UCTIONS OR CERTIFICATE


iving OF DEATH t enter han one for each b) and (c)


ves not mean f dying, such ure, asthenia, is the disease. ations which h.


conditions, ng rise to the : (a) stating ying cause


ions contrib- death but not e disease or using death.


COM IA). 12 49.900722


No.


2 FULL NAMEUNDHY.


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


73 Crystal Cave ave, Winterop? Aass.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


4 days


AGE


Years


7 NAME OF


FUNERAL


wanthay miles


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 helief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imine- cliate 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, b ‹leemed 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 issuc 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 tomh 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 hy 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 seetion 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 eertificate. 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 eertifying the cause of death shall thereafter furnish for registration any other neeessary 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 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 issne 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 reeent medical attendance or whose physician is absent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and eertify to all deaths supposably due to injury. These include not only deaths eaused 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 deatlı.


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 oceupa- tion had been given up or ehanged, 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 oeeupation by the appropriate terms. as housekeeper-private family, cook-hotel, ete. For a person who had no oceupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER


+


PLACE OF DEATH


Suffolk (County)


Chelsea 10/9/6! !


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




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