USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 40
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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 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 arc supposed to have died by violence, or by the action of chemical, thermal or clectrical agents or following abortion, or from discases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable discasc, or when any person is found dead. ... - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Scc. 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 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. 1147 Sec.46 G, L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfilment 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 the ihave given bedside care during a last illness from disease unrelated to any form of inlary (2) of Health physicians will certify to such deathsonly as those of persons, wng. bugy chsabled by recognized disease unrelated to any form of injury, have del futhout 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 jp These include not only deaths caused directly or indirectly by traumelimohouding resulting septicemia), and by the action of chemical (drugs of poisons) thermal, drielectrical 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 occup :- 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
RM R-302 1
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
No.
2 FULL NAME
Baby Boy LcAvoy
(a) Residence. No.
61.Winthrop St
(Usual place of abode)
19
1
have occurred on the date stated above, at
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Septicemia
Due To
Due To
cecum
OTHER
SIGNIFICANT
CONDITIONS
What test confirmed diagnosis?
(Address)
W ... L.Donahue ... JrDate
6
St. Eliz. Hos pt.
June 12/53
25M-3.53-909098
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,
(c)
with peritonitis
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDingle
(write the word)
4 I HEREBY CERTIFY,
That I attended deceased from
53
to
.......
June 10 ......
539
death is said to
alive of
June 10/53
.m.
INTERVAL BE-
10;20PM
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
.Years
Months .. }.
.Days
If under 24 hours
.Hours.
Minutes
13 Usual
Occupation:
(Kind of work done during most of working life)
14 Industry
or Business:
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country)
Boston Mass.
17 NAME OF
FATHER
Gerald F MeAvoy
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Bos.to Mass.
19 MAIDEN NAME
OF MOTHER
Evelyn Mcluenney
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Philx.Pa:
21
Informant
(Address)
Father
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
June 15/53
19
1
C
(Registrar of City or Town where deceased resided)
PARENTS
19 6-10 53 Place of Burial or Benetiendale Cen-Dedcerer Tomas. DATE OF BURIAL
19
7 NAME OF
FUNERAL DIRECTOR
E G Bryant
Somerville Mass.
ADDRESS.
Received and filed.
JUN .... 8.2 1953
19
Bosta
(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
(City or town making return)
Registered No.
5395 21
j(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
(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 Hass
(If nonresident, give city or town and State)
Length of stay: In place of death.
... years ..........
months6
.. days. In place of residence.
.. years
months.
... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
Jun@20/53.
(Year)
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
ANTE
CEDENT (b)
CAUSES
Spontaneous rupture of
Days
Major findings:
Of operations.
Rupture of cecum -peritonitis ...
Date of operation.
.. Was autopsy performed?
Yes
tiure of wound
5 Was disease or injury in any way related to occupation of deceased? If so, specify (Signed). M. D.
PLACE OF DEATH
Suffolk
St. Elizabeth's Hospt.
RECEIVEY
TO:
3
5
6
THROP.
JUN22
AM
..
X
PLACE OF DEATH
(County)
WINTHROP (City or 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.
132
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).
NO
MASS
(If nonresident, give city or town and State)
Length of stay: In place of death 1.8. years. .. months. days. In place of residence 18years.
months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
MALE
9 COLOR OR RACE
WHITE
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDSINGLE
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
2 Dag AGE. 7.4 Years Months Days
If under 24 hours
Hours ...
... Minutes
13 Usual
Occupation :
PRINTER.
(Kind of work done during most of working life)
14 Industry or Business: ROWE ........ BOSTON
15 Social Security No. NONE
16 BIRTHPLACE (City)
(State or country)
IRELAND
17 NAME OF FATHER DANIEL F GALLAGHER
PARENTS
18 BIRTHPLACE OF FATHER (City) DONEGAL
(State or country)
IRELAND
19 MAIDEN NAME OF MOTHER MARY BRADLEY
20 BIRTHPLACE OF MOTHER (City) DONEGAL
(State or country)
IRELAND
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL JUNE171953 19
7 NAME OF FUNERAL DIRECTOR FRANK .... H ... CARR
ADDRESS
79 ELM ST CHARLESTOWN .... MASS.
Received and filed. 1 1 16 1953 19
(Registrar)
C
1953 (Year)
That I attended deceased from 53
to.
6/14
I last saw how
.. alive on
6/14
195 death is said to
3
have occurred on the date stated above, at. 3.45Pm
INTERVAL BE-
TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
ANTE
Due To
Carelocal
CEDENT (b)
CAUSES
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) ...
tvaro Pegan
M. D.
(Address) 670 8 CL6 728, ET Date 6/14
195
6 HOLY CROSS.
MAL.DEN
MASS
50M-5-52-907046
M R-301A 1
No.
1.09PLEASANT
2 FULL NAME. JOSEPH GALLAGHER
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 109PLEASANT (Usual place of abode)
.......
TRUCTIONS FOR L CERTIFICATE
giving : OF DEATH not enter e than one e for each (b) and (c)
s does not mean e of dying, such failure, asthenia, cans the disease, lications which ath.
bid conditions. iving rise to the use (a) stating erlying cause
ditions contrib- he death but not the disease or causing death.
21 JOHN ..... GALLAGHER ..... (.BROTHER.)
Informant (Address) 109 PLEASANT ST WINTHROP:
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter A. Makers. (Signature of Agent of Board of Health or other) healthe Officer 6/16/50
(Official Designation)
(Date of Issue of Permit)
(write the word)
3 DATE OF
DEATH
(Month)
14 (Dáy)
4 I HEREBY CERTIFY,
5/1
19
53
St.
WINTHROP.
Registered No.
DONEGAL
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 whoni 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
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 he 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 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. 14 Sec. #6_G.L., (Tercentenary Edition).
RULES OF PRACTICE
The fairmont of the purpose of these laws calls for the observance of the follow- ing rule pupractice
(1) Attending. physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness front disease unrelated to any form of injury.
2JU jBrard of Health physicians will certify to such deathsonly as those of Hough disabled by recognized disease unrelated to any form of injury, have d ed 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
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 CERTIFICATE OF DEATH
Winthrop
(City or town making return)
133
No. 24 Quincey Avenue
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME Laura .Jane Richards
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 24 Quincey Avenue
St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death. 3.8.years. .... months. .days. In place of residence. .years. .. months. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
June
(Month)
16
(Day)
1953
(Year)
female
white
10 SINGLE
MARRIED
WIDOWED Single
or DIVORCED
1
4 I HEREBY CERTIFY.
Sepot
1951
to ubulun 16
I last saw h. alive on.
Scene 16, 1953, death is said to
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a)
aramamalades
TWEEN ONSET
AND DEATH
11 IF STILLBORN, enter that fact here.
12
3 mes
AGE.7.9 ... Years.
1.0Months .... ] ...
.Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupation:
housekeeper - retired
(Kind of work done during most of working life)
14 Industry
or Business :.
private homes
15 Social Security No.
none
16 BIRTHPLACE (City) ..
(State or country)
Tilstork Shorpshire
england
17 NAME OF
FATHER
Edward Richards
18 BIRTHPLACE OF
FATHER (City)
Staffordshire
(State or country)
England
19 MAIDEN NAME OF MOTHER Margaret Jones
20 BIRTHPLACE OF
MOTHER (City)
Wales
Mass . (State or
country)
21
Informant
Mrs ...... Frank .... D ..... Ross
(Address)
24 Quincey Ave, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter . Maker
(Signature of Agent of Board of Health or other
6 /8,50
(Official Designation)
(Date of Issue of Permit)
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 uth.
id conditions, ing rise to the se (a) stating Flying cause
itions contrib- e death but not the disease or causing death.
50M (A)-1-51 903586
V
arcescarica
1
the ampillar of sted 1/2 yrs
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
geneslagel
Major findings:
Of operations
gen
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 ....
M. D.
(Signed)
(Address)1194200
To reply Sec
attention Date 6 -16
1953
6 Winthrop Cemetery Winthrop,
Place of Burial or Cremation (City or Town)
DATE OF BURIAL June 18 1953 .. 19
7 NAME OF
FUNERAL DIRECTOR
alfred B. Manche
ADDRESS.
174 Winthrop St Winthrop Mass.
Received and filed. 19
(Registrar)
A TRUE COPY ATTEST:
8 SEX
9 COLOR OR RACE
Registered No.
(Was deceased a U. S. War Veteran, [ if so specify WAR) NO
(write the word)
That I attended deceased from
have occurred on the date stated above, at 12:05 Am INTERVAL BE-
ANTE
Due To
CEDENT (b)
CAUSES
AmpUlle
PARENTS
Great Britton Britain
M R-301 T.
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 hody 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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