USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1952 > Part 69
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years
East Boston
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
100M-(D)-10-48-24656
-301A 1
(a) Residence. No. (Usual place of abode)
Winthrop
( if so specify WAR)
(write the word)
September 26, 1952
......
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 effect, specifying the war, and , shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which Shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shallexhume 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,
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 motice 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; ilGeneral Laws, Chap. 38, Sec.6.
I 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 om 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.
CHAB. 114_Sec.46, G. L., (Tercentenary Edition).
6
HROP
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
SER O Fending physicians will certify to such deaths only as those of persons Bey have & van 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 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
-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town) 46 Washington Ave
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent. 203
Registered No.
J(If death occurred in a hospital or institution,
St. ¿ give its NAME instead of street and number)
2 FULL NAME
Archibald
Scott Dalzell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
41 Emerson Rd.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
years
2
months.
days. In place of residence 4.2
.years
months
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
(Day)
That
.I
attended deceased from
to
Sept 28
1952
I last saw h \ alive on
Sept 28
1952 death is said to
have occurred on the date stated above, at
330 A m.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Coronary Thrombosis
1 day
5 yrs. 5 yrs
Due To (c)
OTHER
asterio Selerases
SIGNIFICANT
CONDITIONS
Senility
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 D
Louis 7 Salerno
(Signed)
(Address) 175 Pleasant H.
Date. Sept 29 1952
6 Winthrop
Winthrop
Place of Burial or Cremation
(City or Town)
October 1
19.52
DATE OF BURIAL
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
Received and filed
10/2/52 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
White
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDWidowed
10a If married,
ETfen Bradley
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
12
AGE
Years
5
85
Months
21
Days
If under 24 hours
Hours . . Minutes
13 Usual
Occupation :
Claim Agent
(Kind of work done during most of working life)
14 Industry
or Business :.
Railway Expresss
15 Social Security No.
None
16 BIRTHPLACE (City)
(State or country)
Scotland
17 NAME OF
FATHER
Robert Dalzell
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
19 MAIDEN NAME
OF MOTHER
Christina Scott
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
21 Archibald J Dalzell
Informant
(Address)
41 Emerson Rd. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Watter & to alergy (Signature of Agent of Board of Health or other) Health Office 10/ 1 / 52
(Official Designation) (Date of Issue of Permit)
IONS IFICATE
DEATH ater one each nd (c)
not mean ing, such asthenia, e disease. ts which
nditions. se to the stating cause
contrib- h but not sease or g death.
50M-2-19-25666
No.
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. (Usual place of abode)
Sept.
28
1952
(Year)
4 I HEREBY CERTIFY,
april 7
19
46
wed, or divorced
ANTE
CEDENT
CAUSES
(b)
Chronic Myocarditis
Due To
Hypertension
M. D.
Hamilton
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 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 way and shall also certify in such certificate both the primary and the secondary er inmet !!!. 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 1 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 saidiplu poses, 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 seventeeni G. L. Chap. 46. Sec. 10. 8
No undertaker or other person shall bury or otherwise dispose of a human bod in a town, or remove therefrom a human body which has not been buried, has received a permit from the board of health, or its agent appointed such permits, or if there is no such board, from the clerk of the town e froome when the certificate of death is needed.
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 of the town where the body is buried. No such permit shall be issued uthere 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 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 discases 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, Scc. 6., as amended by Chap. 632, Sec. 4. Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit preceding section or by section forty-five of chapter one hundred and out/ L 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 :
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 an! form of injury.
Board of Health physicians will certify to such deathsonly as those of ns who, though disabled by recognized disease unrelated to any form of sosy, have died without recent medical attendance or whose physician is absent
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 om pisons) 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
....
R-305 1
No.
2 FULL NAME.
(a) Residence.
No.
18
16
Length of stay: In place of death
.years
4
MEDICAL CERTIFICATE OF DEATH
3 DATE OF September
DEATH
(Month)
(Day)
(Year)
Corebral Hemorrhage
5 Accident, suicide, or homicide (specify)
Addident
Date and hour of injury
Aug. 23,
Where did
Manner of
(Specify type of place)
Injury
(How did injury occur?)
unknown
Nature of
While at work?
.Was autopsy performed?
no
no
6 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
(Signed)
Walter F. Mahoney
(AddresWestboro .... Mas
Winthrop
Winthrop.
... Mass ..
Place of Burial, or Cremation.
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-305 to the clerk of the city or town in which the deceased resided as soon as possible
Injury occur?
Grafton Mass.
(City or town and State)
16 Thornton Park.
(Usual place of abode)
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
Injury
Fract. 2-3º
vertebrals
25m-(c)-11-49-900.475
DATE OF BURIAL
Sept. 15,
1952
.....
8 NAME OF
FUNERAL DIRECTOR
George Gook
ADDRESS Governor Ave., Medford, Mass
Received and filed
OCT.14 .... 1952
19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
Femal
10 COLOR OR RACE
Whit
¡11 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Separator
11a If married, widowed, or divorced HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of.
Not learned
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGB.O.
.. Years 1.1 ... Months.
17.Days
If under 24 hours
.Hours ....
.Minutes
14 Usual
Occupation :
Housework
(Kind of work done during most of working life)
15 Industry
or Business:
At home
16 Social Security No ..... not Joannod
not Learned
17 BIRTHPLACE (City).
(State or country)
Denmark
18 NAME OF
FATHER
Frederick Rovers
PARENTS
19 BIRTHPLACE OF
FATHER (City)
not le arned
(State or country)
Denmark
20 MAIDEN NAME
OF MOTHER
Annie Peterson
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Denmark
not le arned
22 Informant Grafton Stale Hospital rcds (Address) North Grafton, Muss
A TRUE COPY.
ATTEST:
Baymany D. Jadan 1.
(Registrar of City or town where death occurred)
DATE FILED
September 16,
RAFTON.
(City or town making return)
Registered No.
204
Grafton State Hospital
Augusta Peters (also known as Anna Marie
(If deceased is a married, widowed or divorced woman, give also maiden name. Peter's )
[(If death occurred in a hospital or institution, St. Į give its NAME instead of street and number)
(Was deceased a
U. S. War Veteran,
no
if so specify WAR)
St.
Winthrop. ... Mass
(If nonresident, give city or town and State)
months. days. In place of residence. .......... years.
months.
days.
Not Learned
12,
1952
4 I 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 was involved, state fully.)
PLACE OF DEATH
WORCESTER (County) GRAFTON . (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
19
52
Did injury occur in or about home, on farm, in industrial place, or in public
place?
State Hospital
M. D.
(City of Town)
.. 19 .....
52
RECEIVED
TOWA
OF
1
10
F
NILS
CLERK
6 5
ASS
HR
OCT14
3
X
PLACE OF DEATH
Suffolk)
Chekaga Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Chelsea (City or town making return)
Registered No.
560
205
J (If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME.
dedelstats a Haried, widowed of divorced woman, give also maiden name.)
-
(Was deceased.3:I
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
(Usual place of abode
50-Moore
St.
Winthrop Lass
(If nonresident, give city of town and State)
Lengthlofotgypilfeld of death
.. years.
months
.days. In place of residence.
......... years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDmiod
4 I HEREBY CERTIFY.
That I
attended deceased from
...
Sopt. 11 152 Wept . 16
19.52.
I last saw
alive om.
m.
sont:16
18 .... , death is said to
have occurred on the date stated above, at ... 00 ...
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a).
hypertensive & rheumtie
ANTE
Due To
CEDENT (b) .... ppart disease
CAUSES
yrs.
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation Was autopsy performed?O
What test confirmed diagnosis? Phys. Exan.
19 MAIDEN NAME
OF MOTHER
Margaret Homon
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Troland
21 Hospital Records
Informant
(Address)
A TRUE COPY. ·Pourl & Tyrrell
ATTEST:
...
(Registrar of City or Town where death occurred)
Received and filed
091-17 1952
St. Winthrop 19
(Registrar of City or Town where deceased resided)
10a If married, widowed, or divorced,
HUSBAND of
Mary B. Murray
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE .!?....... Years.5.
Months.1.5 .... Days
If under 24 hours
Hours .....
. Minutes
13 Usual
Occupation :
Prison Officer (Retired)
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No ......... none
16 BIRTHPLACE (City).
(State or country)
Ireland
17 NAME OF
FATHER
John
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
PARENTS
5 Was disease or injury in any way related to occupation of deceased ?. If so, specify (Signed). (Address). Soldiers Home
odoric M.Howard
M. D.
Day/16/02
19
6
Place of Burial & CroMayo" Boston; Lil (ity or Town) DATE OF BURIAL. Sep .19,1952 19
7 NAME OF
FUNERAL DIRECTOR
Beurice W.Kirby
ADDRESS 810
DATE FILED
Sept.16,1952
19
50m-(e)-10-48-24658
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
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