USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 39
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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.
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 dierk 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).
OF 11 12 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 Exammers 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
Y
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
LY V.
H
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
Nay
To be filed for burial ·permit with Board of Health or its Agent.
128
41 Washington Avenue .... Winthrop No.
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME
Mary. L. Stoliker
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(Was deceased a
U. S. War Veteran,
if so specify WAR)
no
(a) Residence.
No.
(Usual place of abode)
238. .. Woodside Avenue .... Winthrop St.
DEaTR
(If nonresident, give city or town and State)
.. months. .days. In place of residence. .years 1 months .15 days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
female!
white
MARRIED
WIDOWED
or DIVORCED widowed
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Edward N. ... Stoliker
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE. 87.Years
5
Months
6
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:
Housewife
15 Social Security No .. none
16 BIRTHPLACE (City).
(State or country)
Ireland
17 NAME OF
FATHER
Hugh Mclaughlin
18 BIRTHPLACE OF
FATHER (City)
Londonderry
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Bridget McIntyre
5 Was disease or injury in any way related to occupation of deceased?
If so, specify ...........
(Signed)
M. D.
650 PauloJa 13 Date 6/1
19 7 3
20 BIRTHPLACE OF
(Address)
MOTHER (City)
Londonderry
6
Winthrop
Winthrop
Place of Burial or Cremation (City or Town)
DATE OF BURIAL
June .... 3.1953
19
7 NAME OF
FUNERAL DIRECTOR .... Richard. ............. Kirby.
ADDRESS
917 Bennington St. East Boston
Received and filed JUN ..... ] 1953 19
(Registrar)
PARENTS
(State or country)
Ireland
21
Informant
(Address)
Mr.s ..... Sarah ... E ....... Homeyer dau 238 Woodside Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
1
(Signature of Agent of Board of Health or other)
lealtre Chicle 6% 53
(Official Designation) (Date of Issue of Permit)
May 31-64
iving F DEATH t enter han one For each b) and (c)
oes not mean f dying. such ure, asthenia. is the disease, ations which h.
conditions, ag rise to the (a) staling ying cause
ons contrib- death but not e disease or using death.
50M-10-52-908091
3 DATE OF
DEATH
(Monthy
(Day)
That I attended deceased from
4 I HEREBY CERTIFY,
/
19 5
to.
3/30
1953
I last saw h &alive on
5/30; 15 ? death is said to
have occurred on the date stated above, at
2.30Pm.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
a
DIRECTLY LEADING Cleaning Myscon
TO DEATH (a)
ANTE
CEDENT (b)
Due To
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation
Was autopsy performed ?.
What test confirmed diagnosis?
3130
1453 (Year)
PHYSICIAN - IMPORTANT -
Length of stay: In place of death 12 years
RE'S.
UCTIONS FOR CERTIFICATE
R-301A 1
Registered No.
c
Londonderry
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 hy 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, ninet cn hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied. in case of an original inter- ment, by a satisfactory certificate of the attending physician. if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health. or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is
caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose. the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent. upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased. or as to the manner 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 distase or y hen any person is found dead. - General Laws, Chap. 38. Sec, 6, as atheaded by Chap. 632. Sec. +, Acts of 1945.
No undertaker of other persons shell bury a human body or the ashes thereof which have been brought into the coffmonwealth until he has received a permit so to do from theboardof health or its agent appointed to issue such permits, or if there is no such board, from the derk 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 w which the interment is made. .
Chap. 114, S f. Dercentenary 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 hof itrans 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, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION non
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING
ORGANIZATION AND OUTFIT
SERVICE NUMBER
RM R-302 1
T
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible
PLACE OF DEATH
Suffolk:
(County)
Chelsea
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Chelsea
(City or town making return)
286
Registered No.
2 FULL NAME.
Waldo T.Nalone
(If deceased is a married, widowed or divorced woman, give also maiden name.)
34 Banks
St.
Winthrop
(If nonresident, give city or town and State)
months
.......... days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
May 14.1953
DEATH
(Month)
(Day)
(Year)
8 SEX
fale
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDriod
4 I HEREBY CERTIFY,
That I attended deceased from
........ pr .... 10 ...
1953
to May 14
55
I last saw im
alive onay ... 14
ko ...... , death is said to
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
Cancer of
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12 51
5
26
If under 24 hours
AGE
Years
Days
.Hours.
.Minutes
ANTE
Due ToCancer of the
CEDENT (b)
CAUSES
colon
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
Date of operation.
Was autopsy performed?110
What test confirmed diagnosis?clinic.laboratory
5 Was disease or injury in any way related to occupation of deceased ?.
If so, specify
(Signed) Charles T Looney
(Address) Ldiors ..!...
M. D.
Dat 5/14/53 19
6
winthro, Cen., Winthrop Mass
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL.
May 16,1953
19
7 NAME OF
Coward u.Moynolds
FUNERAL DIRECTOR
ADDRESS
180 Winthrop St Winthrop, LASTEST:
Received and filed.
JUN 2 - 1953
19
(Registrar of City or Town where deceased resided)
C
14 Industry
or Business:
15 Social Security No.
cannot be learned
16 BIRTHPLACE (City)
(State or country)
Evorott, Mass
17 NAME OF
FATHER
Henry D.
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Nova Scotia
19 MAIDEN NAME-
OF MOTHER
cie Peterson
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nova Scotia
21 Hospital hocord
Informant
(Address)
A TRUE COPY. Joseph atTurrell
(Registrar/of City or Towy where death occurred)
DATE FILED
May14 1953
.19.
V
50m-(e)-10-48-24658
(City or Town) Soldiers' Home Hospital No.
J(If death occurred in a hospital or institution,
St. \ give its NAME instead of street and number)
WWI
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence.
No.
(Usual place of abode)
hospital
Length of stay: "In place of death ....
yeats
months4 ......... days. In place of residence ....
.years .....
10a If married. widowed, or divorcech ton
HUSBAND of SOLOHT ONNYUG
(Give maiden name of wife in full)
have occurred on the date stated above. at.
9:25A.
m.
INTERVAL BE-
TO DEATH (a)
the liver metastatic
p mos
Electrician
13 Usual
Occupation :
(Kind of work done during most of working life)
(write the word)
RECEIV. 0
TOW
11 12 1
?
Milli
-3
5
INTHROP
JUN23 AN
Enlisted 6/13/18 Discharged 9/2/19 Trumpeter USMC 123 789
A R-301A 1
PLACE OF DEATH
*
Suffolk (County)
Winthrop (City or Town)
VIEW Test Ml
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 ite Agent.
.... 20
No. 41 Washington Ave. Sarah Elizabeth (Maloney ) Dunn
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME ...
(If deceased is a married, widowed or divorced woman, give also maiden name.)
10 Perkins St.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. years. 8 months .days. In place of residence .years .months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
Female White
MARRIED
WIDOWED
or DIVORCED
Marrie
4 I HEREBY CERTIFY,
1952
to.
June 5
1953
A last saw h be alive on
16/5/ 193.
death is said to
have occurred on the date stated above, at
6A
m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN. enter that fact here.
12
AGE
Years
76 9
Months .
O
Days
If under 24 hours
.Hours
.Minutes
13 Usual
Housewife
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
At home
15 Social Security No.
None
Boston
16 BIRTHPLACE (City).
(State or country)
Mass
17 NAME OF FATHER Edward H Maloney
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mas
S
19 MAIDEN NAME
OF MOTHER
Sarah E McDonald
20 BIRTHPLACE OF
197
MOTHER (City)
Boston
(State or country)
Mass
21 Edward F Dunn (Address) Informant 10 Perkins St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Walter A. Habere
(Signature of Agent of Board of Health or other) Theattle affecte 6.10.5.3
(Official Designation) (Date of Issue of Permit)
50M-2-19-25666
7 NAME OF
FUNERAL DIRECTOR:
Stoward Stlasnill
ADDRESS
Received and filed. 11/0, 11953 19
(Registrar)
C
7 1953 (Year)
(Month)
(Day)
That I attended deceased
from
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Edward F Dunn
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING ?
TO DEATH (a).
Cerebral Tambien
ANTE
Carcinoma
CEDENT (b)
CAUSES
Large Baril (Sig)
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)
Fixed O Declan M.D
M. D.
(Address) 676 SabatoJust 4. buto Date 6/2
Winthrop
Winthrop (City or Town)
6
Place of Burial or Cremation
DATE OF BURIAL June 10
1953
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such ilure, asthenia, ans the disease, cations which th.
id conditions. ing rise to the e (a) stating lying cause
tions contrib- death but not he disease or ausing death.
(a) Residence. No. (Usual place of abode)
30
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
3 DATE OF
DEATH
June
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 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
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