USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 46
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The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return)
6192 150
Registered No.
1(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
Mary S. McInerny
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
117 Shore Dr. Winthrop
(Was deceased a
U. S. War Veteran,
if so specify WAR)
no
(a) Residence. No.
(Usual place of abode)
7
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
......
.years.
.months
days. In place of residence.
... years ..
.. months.
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
July 6, 1953
DEATH
(Month) (Day)
(Year)
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof yurtdom (an injury was involved, state fully.)
and laceration of brain-fracture of skull-accidentally incurred.
Infol1-ACCIDENT JJUNE-271953. Winthrop-home accidental fall
5 Accident, suicide, or homicide (specify)
Date and hour of injury
19
Where did
Injury occur?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place?
Manner of
Injury
(How did injury occur?)
Nature of
Injury
While at work?
Was autopsy performed?
yes
6 Was disease or injury in any way related to occupation of deceased?
If so, specify
Michael A. Luongo
M. D.
(Address)
Mt. Pleasant Arlington
7
Place of Burial, or Cremation.
July 9, 1953
19
Town)
DATE OF BURIAL.
8 NAME OF
FUNERAL DIRECTOR
... Maurice .... W ...... Kirby
ADDRESS.
WINTHROP.
Received and filed 19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
femn.
10 COLOR OR RACE
wifi e
11 SINGLE
(write the word)
MARRIED widowed
WIDOWED
or DIVORCED
11a If married, widowed, or divorced
HUSBAND of ...
Patric Give Lidemernewie in full)
... (or) WIFE of (Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE
Years
.Months.
Days
If under 24 hours
Hours.
. Minutes
14 Usual
Occupation:
(Kind of work done during most of working life)
none
15 Industry
or Business:
none
16 Social Security No.
17 BIRTHPLACE (City)
(State or country)
John O'Brien
18 NAME OF
FATHER
19 BIRTHPLACE OF
FATHER (City).
(State or country)
Ireland
20 MAIDEN NAME Catherine Keane OF MOTHER
21 BIRTHPLACE OF
Ireland
19
MOTHER (City)
(State Jrskuptry)Ic INERNEY
ArtIngton, Mass.
22 Informant (Address)
A TRUE COPY. JULY 10, 1953
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILMarLes H. Mackie
19
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
25m-(c)-11-49-900.475
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
1
No.
PLACE OF DEATH
R-305 1
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
PARENTS
(Signed)
25 Shattuck st.
7-7-53 Date
(Specify type of place)
Ireland
...
-
TO
11 12.
MINI
5
7
THROP.
JUL20 AM
R-305 1
PLACE OF DEATH
(City or_Town) 818 Harrison Ave
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON
(City or town making return) 6181451
Registered No.
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Arthur L O' Leary
2 FULL NAME (If deceased is a married, widowed or divorced woman, give also maiden name.) 117 Nahant St
(Was deceased a U. S. War Veteran, if so specify WAR)
WW I
Lynn Mass
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death. ...... .years. .months. .days. In place of residence. ...... .... years ..
months.
.. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
July 6, 1953
DEATH
(Month)
(Day)
(Year)
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.)
Rheumatic heart disease
5 Accident, suicide, or homicide (specify).
Date and hour of injury. 19
Where did Injury occur ?. (City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
Manner of
Injury
(How did injury occur?)
Nature of
Injury
While at work?
.Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased? If so, specify.curtis (Signed) .25 Shattuck St
7/6 M. 53
(Address) Winthrop Cem
winthrop Mass
7 Place of Burial, or Cremation.
Jul Cityor Town) 53
DATE OF BURIAL.
19
8 NAME OF
FUNERAL DIRECTOR
# T Bulger
ADDRESS Boston Mass
Received and filed. 19
......
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
9 SEX Male
10 COLOR OR RACE
white
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Married
11a If married, widowed, or yourdence M Daley
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN. enter that fact here.
13
56
26
AGE
Years.
Months.
.Days
14 Usual
Occupation :.
(Kind of work done during most of working life)
15 Industry
or Business:
011-052-5982
16 Social Security No.
Boston Mass
17 BIRTHPLACE (City).
(State or country)
18 NAME OF FATHER
Cornelius O'Leary
PARENTS
19 BIRTHPLACE OF
Ireland
FATHER (City) (State or country)
20 MAIDEN NAME
OF MOTHER
Mary O'Meara
21 BIRTHPLACE OF
Ireland
22 Informant (Address) .
A TRUE COPY. Cory Charles H. Mackie
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
.......... July 9 .19. 53
VIV
0
25m-(c)-11-49-900.475
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 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?
JINTtill
ST. SUFFOLK "BOSTON
No.
St.
(If nonresident, give city or town and State)
If under 24 hours
Hours
Minutes
Clerk
(Specify type of place)
.Date. 19 ........ MOTHER (City) (State or country) Hife
TO
1
pull.
7
THROP
JUL 19 AM
20 1953
Oct 22, 1917 Apr 26, 1919 PFC Ambulance Service 520 Sect. 643096 640396
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
To be filed for burial ·permit with Board of Health or its Agent.
152
2 FULL NAME .. Helena .... Peers .... Malone (If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 9 Lincoln St (Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. years months. ..... days. In place of residenceO
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
July
9
1953
(Year)
(Month)
(Day)
That I attended deceased from
0
53
I last saw h .......... alive on.
have occurred on the date stated above, at 1:308 m.
INTERVAL BE- TWEEN ONSET ANO DEATH
11 IF STILLBORN, enter that fact here.
12
AGE77.
Years
.Months.
Days
If under 24 hours
Hours .. . Minutes
13 Usual
Occupation:
Housewife
(Kind of work done during most of working life)
14 Industry
or Business: Own
Home.
15 Social Security No.
East ... Boston
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
John Peers
18 BIRTHPLACE OF
FATHER (City) East
Boston
(State or country)
Mass
19 MAIDEN NAME OF MOTHERRobena Gillies
20 BIRTHPLACE OF MOTHER (City) (State or country)
England
21 InformanMary J. McConnell
(Address)
9
Lincoln St
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter G. Raken.
(Signature OLA LaDof Beck of Health or other) 7/10/53
(Official Designation)
(Date of Issue of Permit)
C
yss.
ANTE
Due To
CEDENT (b)
CAUSES
generalizal
Due To (c)
OTHER
SIGNIFICANT Surance Valmer
CONDITIONS
licor descore
Typo.
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).
Whaling Con due Date 7-10
M. D.
19.45
6 Woodlawn
Everett
(City or Town)
DATE OF BURIAL
JULY 11 1953
19
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
MAnthrop
Received and filed.
JUL 10 199 1953
19
(Registrar)
8 SEX
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or Divodoumed
(write the word)
4 I HEREBY CERTIFY,
19€ 2
to.
Shelly 47 5 death is said to
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE Elias A. .. Malone
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
) Myacontece
I heart oficeone
Female
(Was deceased a U. S. War Veteran, if so specify WAR)
UCTIONS OR CERTIFICATE
iving F DEATH t enter han one or each ) and (c)
Does not mean dying, such ure, asthenia. s the disease. tions which *1
conditions. g rise to the (a) stating ying cause
ons contrib- death but not e disease or using death.
50M-3-53-909098
R-301A 1
Registered No.
No. 9.Lincoln St
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
.years. months days.
MEDICAL CERTIFICATE OF DEATH
PARENTS
Place of Burial or Cremation
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 'or 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 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 of following abortion, or from diseases resulting from injury or infection relating. toroccupation, or suddenly when not disabled by recognizable disease, or wben 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 buffy & huurany 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 brits 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 person apointed to have the care of the cemetery or burial ground in whey was made.
Chap. 114, Sec. 46, G. L .;. f THREE Edition).
RULES OF PRACTICE
The fulfillment of the purpose of fire rw Falls 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 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
1 PLACE OF DEATH
Luftalle "(County),
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
153
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)
{If deceased is a married, widowed or divorced woman, give also maiden name.) 5€ Merre AV
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. years. .months. 1 days. In place of residence .years .months days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
11.
1453
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
11
1953
195
to.
Sal 11
I last saw h/M alive on Call H
1253
death is said to
have occurred on the date stated above, at 422.P.
.m.
DISEASE OR CONDITION
DIRECTLY LEADING
acute
TO DEATH (a)
Coronary Yhmaloes.
ANTE Due To CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations
Date of operation
Was autopsy performed? no
What test confirmed diagnosis ?.
nothing
5 Was disease or injury in any way related to occupation of deceased?
If so, specify ... "
(Signed)
(Address) 26 Breed H Kh Date( Let, 16)
1953
6
Place of Burial or Cremation
(City of Town)
DATE OF BURIAL
July 14
19
7 NAME OF
FUNERAL DIRECTOR,
ADDRESS
Received and filed
JUL .1.4 1953
19
(Registrar)
0
PERSONAL AND STATISTICAL PARTICULARS
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) Passed
10a If married, widowed, or divorced HUSBAND of. (Give maiden name of wife in full)
·Chili
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
6 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. Juice
16 BIRTHPLACE (City). (State or country)
17 NAME OF FATHER
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
19 MAIDEN NAME OF MOTHER
20 BIRTHPLACE OF MOTHER (City) (State or country)
1
21 Aus Madel Me Voured
(Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued! Walter & Bakery (Signature of Agent of Board of Health or other)
I health Placer 7.14.53
(Official Designation) (Date of Issue of Permit)
CTIONS OR 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) stating ing
ons contrib- eath but not disease or using death.
1 - R.
R-301A 1
(City or Town)
No.
2 FULL NAME
(a) Residence. No. (Usual place of abode)
8 SEX
Mali
I file
INTERVAL BE- TWEEN ONSET AND DEATH
almt
9 30
50M (B)-1-51 903586
D. Thomas
M. D.
7.
To be filed for burial permit with Board of Health or its Agent.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical TOW Lafcer, shall forthwith. after the death of a person whom he has attched queny bis last illness, at the request of an undertaker or other authorized person draf any member of the family of . the deceased, furnish for registration a standard'dertig for of death, stating to the best of his knowledge and belief the name of the deceased this supposed age, the disease of which he died. defined, as feqjured section ere, where same was alive by the physician 44. Sec. 9. :
contracted. the duration of his last illness SE or officer and the date of his death. In. LSTV. Chop.
A physician or officer furnishing preceding section or by section foly teen, shall. if the deceased, to the best! army, navy or marine corps of the United engaged. insert in the certificate a recita shall also certify in such certificate both the f
Scate f .Heath as required by the pe hundred and four- knogle d belief, served in the in which it has been pccifying the war, and 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 section fo yleve, forty- and forty-seven of said chapter one hundred and fourtcen War" shall include the China relicf 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 be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
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