Town of Winthrop : Record of Deaths 1953, Part 37

Author: Winthrop (Mass.)
Publication date: 1953
Publisher:
Number of Pages: 600

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 37

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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 beliet) served in the army, navy or marine corps of the United States in any way in which it Has been engaged, insert in the certificate a recital to that effect, specifying He wer, apd shall also certify in such certificate both the primary and the secondary. on diate cause of death as nearly as he can state the same. For neglect/upromoply with any provision of this section, such physician or officer, shall forfelt ten theillays. 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, forward and deemed to have taken place between February fourteenth, eighteen fuer 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 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, 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 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.

SI 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 hody is to be buried for the funeral is to he held, or from a person appointed to have the care of the A 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- Iny 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 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, eook-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

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

Winthrop 1200 (City or town making return)

Registered No.

No. .

Winthrop Community Hospital

[(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)

2 FULL NAME. Bernard .... RoscoeSlocum

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

(a) Residence. No. 235 Washington Avenue St.

(Usual place of abode)

(If nonresident, give city or town and Stale)

Length of stay: In place of death. ........ ... years. months. 3 ... days. In place of residence. 35.years .. months .days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

3 DATE OF

DEATH

May

1953

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY,

That I attended deceased from

april 28

1950

to.

May 27

1953

I last saw

alive on May 27, 153

death is said to

have occurred on the date stated above, at. INTERVAL BE-

DISEASE OR CONDITION DIRECTLY LEADING TO DEATH

(2) Parent thrombosis of

main branch of it. commary antony

2 days

AGE.70 Years .... 6 Months ... 14 Days

If under 24 hours

.Hours .

.Minutes

ANTE

Due

acute Myocardial

CEDENT (b) CAUSES Infarction (protein)

Due To Chimie passie

1-2

15 Social Security No.

011-07-1587

16 BIRTHPLACE (City) ..

Bridgetown

(State or country) Nova Scotia

17 NAME OF FATHER Major Slocum

18 BIRTHPLACE OF

FATHER (City)

Bridgetown

(State or country)

Nova Scotia

19 MAIDEN NAME

OF MOTHER

Azuba Messinger

20 BIRTHPLACE OF

MOTHER (City)

Bridgetown

(State or country)

Nova Scotia

21 Informant Mrs ...... Bernard ... R ........ Slocum 235 Washington Ave.

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

Mass. Walter It take

(Signature of Agent of Board of Health or other) Health Officer 5.29.53

(Official Designation) (Date of Issue of Permit)

A TRUE COPY ATTEST:

WPARENTS

5 Was disease or injury in any way related to occupation of deceased No If so, specif. M. D. Jacob & Chiamo 3 440 (Signed). (Address) 562 Ariely St. Guairago 5/20100

6 ... Winthrop .Cemetery Winthrop Mas's Place of Burial or Cremation (City of Town) .

DATE OF BURIAL .....

May 29 1953

19 :....

(Address)

7 NAME OF

FUNERAL DIRECTOR

Lelked B Mark

ADDRESS.

174 Winthrop St. Winthrop,

Received and filed. 19

(Registrar)

8 SEX male white

9 COLOR OR RACE

10 SINGLE

(write the word)

MARRIED WIDOWED or DIVORCED

married

10a If married, widowed, or divorced

HUSBAND of

Madeline Foote

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

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

13 Usual

Occupation :.... paper ... salesman

(Kind of work done during most of working life)

14 Industry

or Business:

wholesale ... paper .Co.

Injection of liver

OTHER atelectasia of ax ln alote

WSIGNIFICANT Clinical chalets mellitus doup

Major findings:

Of operations.

une

Date of operation.

Was autopsy performed? glo

What test confirmed dia

clinical + pathological

3 hrs.

11818140315

50M (A)-1-51 903586

CTIONS ERTIFICATE iving F DEATH tenter han one or each ) and (c)

es not mean dying, such re, asthenia. s the disease. tions which .

conditions. g rise to the (a) staling ing cause

ms contrib- eath but not disease or using death.

I R-301 1

CERTIFICATE OF DEATH

(Was deceased a U. S. War Veteran, if so specify WAR). NO.

11:30 Am.

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 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 shan forthwith go to the place where the body lies and take charge of the same; General Laws, Chap. 32, Sec. 6. 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 E Examiner has notice that there is within his county the body of such a person, he best of his knowledge and belief the name of the deceased, his supposed age, the discase 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 o+ officer end 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, inscrt in the certificate a recital to that effect, specifying the warand shall also certify in such certificate both the primary and the secondary or-Hunc .: diate cause of death as nearly as he can state the same. For neglect tocomply 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-scher of said chapter one hundred and fourteen, the word "war" shall include the Chair relief expedition and the Philippine insurrection, which shall, for said purposes An deemed to have taken place between February fourteenth, eighteen hundred an ninety-eight,and July fourth, nineteen hundred and two, and the Mexican bordex service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.

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 regist ra- 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).

OF Noundertaker or other persons shall bury a human body of 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 Lhagen's no such board, from the clerk of the town where the body is to be buried L'or the Finetitlis to be held, or from a person appointed to have the care of the cemetery of burial ground in which the interment is made.

háp, 14. Sec. 46, G. L., (Tercentenary Edition).

RULES OF PRACTICE

6 artillment of the purpose of these laws calls for the observance of the follow-

THREE. · 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 in jury. (2) Board of Health physicians will certify to such deaths only as those of

No undertaker or other person shall bury or otherwise dispose of a human bay Gons who,though disabled by recognized disease unrelated to any form of

frydry, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.

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 homc. 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

1 .

after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time ,

PLACE OF DEATH

FRANKLIN (County)

ORANGE

(City or Town)

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

ORANGE

(City or town making return)

123

J(If death occurred in a hospital or institution, St. į give its NAME instead of street and number)

2 FULL NAME

Vida (Maclean) Ioos

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

(Was deceased a

U. S. War Veteran,

if so specify WAR).

St.

Winthrop, Mass

(If nonresident, give city or town and State)

Length of stay: In place of death. ........... years. ...... .months. ........ days. In place of reside

8.6.years.

months.

16 ays.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

3 DATE OF

DEATH

May

1953

(Month)

(Day)

(Year)

8 SEX

Female

9 COLOR OR RACE

White

10 SINGLE

MARRIED

WIDOWED

or DIVORCED

Widowed

4 I HEREBY CERTIFY,

May

28.

May

28.

I last saw h ...

May

28.

19.53

death is said to

have occurred on the date stated above, at.

11-50 A .M.

INTERVAL BE-

DISEASE OR CONDITION DIRECTLY LEADING

TO DEATH (a)

Coronary Thrombosis

TWEEN ONSET AND DEATH 4 hrs

ANTE

Due To

CEDENT (b)

CAUSES

Due To (c)

OTHER

SIGNIFICANT

CONDITIONS

Major findings:

Of operations.

Date of operation

Was autopsy performed?

What test confirmed diagnosis ?.. Physicial ... and .... Clinical

PARENTS

18 BIRTHPLACE OF

Sussex,

FATHER (City)

(State or country)

New Brunswick

19 MAIDEN NAME

OF MOTHER

Annie Lee

20 BIRTHPLACE OF

MOTHER (City)

Mill Stream

Springfield Crematory,

Springfield, Mass

(State or country)

New Brunswick

Place of Burial or Cremation

(City or Town)

DATE OF BURIAL

June

19.53

7 NAME OF

FUNERAL DIRECTOR

Roya A. Ward

ADDRESS

Orange ,Massachusetts

Received and filed.

(Registrar of City or Town where deceased resided)

10a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

Leon Bertraad Ioos

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGE

Years

Months

Days

If under 24 hours

.Hours.

Minutes

13 Usual

Occupation:

At Home

(Kind of work done during most of working life)

14 Industry

or Business:

None

15 Social Security No.

16 BIRTHPLACE (City).

(State or country)

Sussex,

New Brunswick

17 NAME OF

FATHER

Arthur

MacLean

5 Was disease or injury in any way related to occupation of deceased ?. If so, specify

(Signed).

Harold ... R ..... Mahar

M. R.

(Address) Orange ......

Mass

Date ...

5/28/

19 53

21 Informant.Mrs Grace M Millen (Address) 75 East Main St. Orange, Mass.

A TRUE COPY.

Robert anderson

ATTEST:

(Registrar of City or Town where death occurred)

DATE FILED

May

28,

..........

.19 ... 53

50m-(e)-10-48-24658

R-302 1

Registered No.

No. Eastern Star ..... Home

......

(a) Residence. No. 26 Sturges (Usual place of abode)

That I

attended deceased from

(write the word)

IF TOW

11 12 1

Orr

INT

JUN-2

COPY OF CERTIFICATE OF DEATH

CERTIFICATE OF DEATH STATE OF NEW HAMPSHIRE

TOWN OR CITY CLERK'S NO

1. NAME OF

DECEASED

(Type or Print)

a. (First)

Ida

b. (Middle)

Labelle

c. (Last)

Dunn

2. DATE

DEATH

(Month) AY

(Day)

29,

(Year)

1953

3. PLACE OF DEATH

a. COUNTY

Rockingham

b. COUNTY

a. STATE

Strafford

4. USUAL RESIDENCE (Where deceased lived. If institution: resid-

N. H.

ence before admission).

b. CITY

TOWN

Exeter

c. LENGTH OF

STAY (in this place)

WOOKB

c. CITY (Give actual town of residence, NOT mailing address).

TOWN

Dover, N. H. (Madbury)

d. FULL NAME OF (If not in hospital or institution, give street address or location)

HOSPITAL OR

INSTITUTION

d. STREET

ADDRESS

R.F.D. #2

5. SEX

Female

6. COLOR OR RACE

Whit

7. MARRIED, NEVER MARRIED, 8. DATE OF BIRTH

WIDOWED. DIVORCED (Specify)

widowed

9. AGE (In years

last birthday)

IF UNDER 1 YEAR Months!

Days

IF UNDER 24 HRS.

Hours

10a. USUAL OCCUPATION (Kind of work

done during most of working life, even if retired)

Housewife

10b. KIND OF BUSINESS OR IN-

Own Home

DUSTRY

11. BIRTHPLACE (State or foreign country)

Winthrop, Mass.

12. CITIZEN OF WHAT

COUNTRY?

U.S.

13. FATHER'S NAME

Ephraim Duck Floyd

14. MOTHER'S MAIDEN NAME

Sarah Elizabeth Wyman

15. WAS DECEASED EVER IN U. S. ARMED FORCES?

(Yes, nogor unknown) | (If yes, give war or dates of service)

16. SOCIAL SECURITY 17. INFORMANT

NO.

Wrs. Schwin Frank Tucker

18. I. DISEASE OR CONDITION DIRECTLY LEADING TO DEATH This does not mean the mode of dying, such as heart failure, asthenia, etc. It means the disease, injury, or complication which caused death.

(a) ..

DUE TO

(b)

DUE TO

MEDICAL CERTIFICATION

Generalized carcinomatosis

INTERVAL BETWEEN

ONSET AND DEATH

5 2008.

Carcinoma Breast

6 mos.

II. OTHER SIGNIFICANT CONDITIONS Conditions contributing to the death but not related to the disease or condition causing it.

19a. DATE OF OPERA- 19b. MAJOR FINDINGS OF OPERATION TION

20. AUTOPSY?

YES

21a. ACCIDENT

SUICIDE

HOMICIDE

(Specify)

21b. PLACE OF INJURY (e.g., in or about

home, farm, factory, street, office bldg., etc.)

21c. (CITY OR TOWN)

(COUNTY)

(STATE)

21d. TIME

INJURY

(Month) (Day) (Year) (Hour)

21e. INJURY OCCURRED

WHILE AT

WORK

21f. HOW DID INJURY OCCUR?

22. I hereby certify that I attended the deceased from

alive on

5/29

93, and that death occurred at

12:10

. 19 .__. , that I last saw the deceased ne., from the causes and on the date stated above.

23a. SIGNATURE

Geo. O. McGregor

( Degree or title)

Fer

23b. ADDRESS

Durham, N. Il.

23c. DATE SIGNED

5/29/53

24a. BURIAL. CREMATION. ENTOMBMENT REMOVAL ( Specify)

24b. DATE

6-1-53

24c. NAME OF CEMETERY OR CREMATORY

Winthrop Cemetery

24d. LOCATION (City, town, or county ) (State)

Winthrop, Mass.

1F ENTOMBED 24e PLACE OF BURIAL

( Name of Cemetery)

LOCATION (City, Town, County) ( State)

DATE

NOT WHILE

AT WORK

12/10 52

to.

5/29

ANTECEDENT CAUSES

Morbid con-

ditions, if any, giving rise to the above cause

(a) stating the underlying cause last.

(c)

Min.

July 2, 1872

(If rural, give location)

Exeter Hospital

121

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.

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Town of Winthrop : Record of Deaths 1953, Part 37

Author: Winthrop (Mass.) Publication date: 1953 Publisher: Number of Pages: 600

Author: Winthrop (Mass.)
Publication date: 1953
Publisher:
Number of Pages: 600