USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1952 > Part 33
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10a If married, mouwed, or dy HUSBAND of.
(Was deceased a U. S. War Veteran, if so specify WAR)
200.
(If nonresident, give city or town and State)
(Give maiden name of wife in full)
19 .. 50
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 lath of a person whom he has attended during his last illness, at the request an malertaker or other authorized person or of any member of the family of the le ease l furnish for registration a standard certificate of death, stating to the best f his knowledge and belief the name of the deceased, his supposed age, the I ( se f which he died, defined as required by section one, where same was districtel, the duration of his last illness, when last seen alive by the physician . fl. er a 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- teer. s' all if the decease 1, to the best of his knowledge and belief, served in the rmy i ws r marine corps of the United States in any war in which it has been engaged j.sert in the certificate a recita! t , that effect, specifying the war, and spills certify in such certificate both the primary and the secondary or imine- diate cause of death as nearly as he can state the satte. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes ( i this se .t. on and of sections forty-five, forty-six and forty-seven of -ul chapter one hundre land fourteen, the word "war" shall include the China re'tef expedition and the Philippine insurrection, which shall. for said purposes, b her ed t' have taken place between February fourteenth, eighteen hundred and mecty-eigh' und July fourth, nineteen hundred and two, and the Mexican border service f nineteen hundred and sixteen and nineteen hundred and seventeen. (r. 1 .. Chap. 46. Sec. 10.
No undertaker brother person shall bury or otherwise dispose of a human body in a town, or rem we therefrom a human body which has not heen buried, until he has re eived a permit from the board of health, or its agent appointed to issue such perniits, 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 lown, 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 pern it from the hoard of health or its agent aforesaid or from the clerk if the town where the body is buried. No such permit shall be issued until there Full 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- mert, by a satisfactory certificate of the attending physician, if any, as required by lav, or in heu 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 hy the selectmen for the purpose, shall upon appl ation make the certificate required of the attending physician. If death is cal sel 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 t 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; pr vided, that such body shall be returned to the town from which it was removed withm thirty- six hours after such removal, unless a permit in the usual i'm 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 pernuit 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 elerk 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 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 he 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)
Winthrop (City or Town)
No. Winthrop
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
93
2 FULL NAME. Tilliam P .. .... Vance.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 40 Lincoln St
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death years. months .... days. In place of residence .years .. months .. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
(Month)
12
(Day)
1952 (Year)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
(write the word)
MarWIDOWED BT DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
April, 5. 1952 to April 11 19:02
I last saw h I hh alive on April 11. 195 death is said to
have occurred on the date stated above, at
4.9
m.
INTERVAL BE-
TWEEN ONSET
DISEASE OR CONDITION Esophageal DIRECTLY LEADING
AND DEATH
TO DEATH (a)
Esophageal Hemmorman
6 days
ANTE
Due To
·Senile Arterio -
CEDENT (b)
CAUSES
Sclerosis .
(c)
Due To Cirrhosis of Liver
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations
22000
Date of operation
none
Was autopsy performed?
Clinical Signs
200
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
(Address)
mis anthrop
M. D.
Date /04/121952
Holy
Cross
Malden
6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL.
April
14 1952
19
7 NAME OF
FUNERAL DIRECTOR.
John & Omaley.
ADDRESS
Received and filed.
19
APR 14 1050
»(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
England
19 MAIDEN NAME
OF MOTHER
Mary Davy
20 BIRTHPLACE OF
MOTHER (City)
Brazil
(State or country)
So. America
21
Informant
(Address)
40
Lincoln St
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit perunit was issued:
Walter . Baker
(Signature of Agent of Board of Health of other)
Thealth Sphere 4/12/22
(Official Designation) (Date of Issue of Permity
ONS FICATE
EATH ter one ach d (c)
ot mean ng. such sthenia, disease, which
ditions. e to the stating cause
contrib- but not ease or g death.
50M-(D)-6-51-904917
11 IF STILLBORN, enter that fact here.
12
AGE85
Years
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
OccupRientired)
Railroad
(Kind of work done during most of working life)
14 Industry
or Business:
Railroad
-
15 Social Security
031 -- 05 -- 7891
16 BIRTHPLACE (City).Dublin
(State or country)
Ireland
17 NAME OF
FATHER
Gilbert
Vance
200
What test confirmed diagnosis?
10a If married, widowed, or divorced
HUSBAND of.
Annie.
Mullen
(Give maiden name of wife in full)
(or) WIFE of (Husband's name in full)
32
To be filed for burial permit with Board of Health or its Agent.
Community Hospital
J(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)
PERSONAL AND STATISTICAL PARTICULARS
Edith
Vance
Winthrop
301A 1
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating tn 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 offieer 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 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 ninetcen 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 hy, 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 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 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 registratinn any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114. Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. _ - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632. Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have heen 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
02
1
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
3548
94
2 FULL NAME.
Ben jamin J Daunt
(If deceased is a married, widowed or divorced woman, give also maiden name.)
96 Taft Ave.
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 15
days. In place of residence.
.......
.years.
months
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April 13/52
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
March 30
19
52
April 13
52
19
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 54
Years
7
Months.
29
.Days
If under 24 hours
Hours ....
Minutes
13 Usual
Occupation:
Salesman
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
Boston Moss.
17 NAME OF
FATHER
Frank Daunt
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland.
19 MAIDEN NAME
OF MOTHER
Mary Seeley
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Mt Hope Boston Mass.
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL April 16/52 19
21
Informant
(Address)
V ... A.Hospt Records
A TRUE COPY
ATTEST: Karles H. Mackie
(Registrar of City or Town where death occurred)
DATE FILED
April 17/52
...... .19 ..
(Registrar of City or Town where fegeased resided) 1952
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
have occurred on the date stated above, at.
12;30A
m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Chronic pyelonephritis
Yrs
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Was autopsy performed?
No
Date of operation
What test confirmed diagnosis@linical and lab. findings
5 Was disease or injury in any way related to occupation of deceased ?...... N.Q. If so, specify. S-Stewart
(Address)
(Signed).
West Roxbury Massate
4-13 19 52
M. D.
7 NAME OF
FUNERAL DIRECTOR
Brookline Mass.
ADDRESS
Received and filed. 19
PARENTS
25m-(b)-11-49-900,475
PLACE OF DEATH
Suffolk (County)
No.
Veteran's Adm.Hospt
J(If death occurred in a hospital or institution.
St. [ give its NAME instead of street and number)
W W #1
(Was deceased a
U. S. War Veteran,
if so specify WAR)
7
That
I attended deceased
from
to
I last saw h
...... alive on
19
death is said to
G.
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
FH Lally
V
APR25
00 10
L
6
-
Entered Service 7-7-18
Discharged 9-24-18
Private U S Marine Corps Service No. 129038
+
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.
3545
95
2 FULL NAME
William R McDermott
(If deceased is a married, widowed or divorced woman, give also maiden name.)
29 Triton Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
.years
months.
18
.days.
In place of residence.
12
.years.
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
April 14/52
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased
from
March 27 19 52
to.
April 14
19
52
I last saw h
im.alive on
April 14 19 52
ath is said to
have occurred on the date stated above, at
2:40PM
m.
INTERVAL BE.
11 IF STILLBORN, enter that fact here.
12
56
AGE
Years.
Months.
Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation:
Yard Master
(Kind of work done during most of working life)
14 Industry
or Business:
Railroad
15 Social Security No.
714-104-078
16 BIRTHPLACE (City)
(State or country)
Worcester Mass.
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
None during this admission
Yes
Date of operation
Was autopsy performed?
What test confirmed diagnosis ?.
autopsy
PARENTS
19 MAIDEN NAME
OF MOTHER
Mary Murphy
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
Place of Burial or Cremation (City or Town)
DATE OF BURIAL.
April 17/52
19
21
Informant
(Address)
W R McDermott Jr.
7 NAME OF
FUNERAL DIRECTOR
E Caggiano
ADDRESS Winthrop Mass.
Received and filed. APR. 19
MAR 2.5 1952
(Registrar of City or Town where deceased resided)
8 SEX
M
9 COLOR OR RACE
W
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Married
If married, widowed, or div
Gertrude Foley
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Recurrent carcinoma
sigmoid with regional
of
metastases
Due To
ANTE
CEDENT (b)
CAUSES
Bilateral hydronephrosis
Due To
Purulent bronchitis
(c)
cachexia
7 Yrs
Mos
25m-(b)-11-49-900,475
·
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 after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
302
1
No.
Peter Bent Brigham Hospt
j(If death occurred in a hospital or institution.
St. [ give its NAME instead of street and number)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Winthrop Mass.
(a) Residence. No. (Usual place of abode)
(Signed)
Peter Bent Brigham Hospt -Mi-52
(Address).
Winthrop vem-Winthrop Mass.
6
5 Was disease or injury in any way related to occupation of deceased?
If so, specify
V"Cas's
17 NAME OF
FATHER
William McDermott
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
A TRUE COPY
ATTEST:
Only & Mackie
DATE FILED
(Registrar of City or Town where death occurred) April 17/52
19
RECEIVED
11 12
8
7
5
6
APR25
PLACE OF DEATH
+ Suffolk (Cotinty)
Winthrop (City of 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.
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