USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 50
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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 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 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. 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- (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 ingury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (draugs ør 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 Statement of Cause of Death .- Physicians: see explanatory instructions 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 £ RM R-302 1 WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD (Address) 6 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, CONDITIONS PLACE OF DEATH Suffolk (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 Boston (City or town making return) Registered No. 68151.6.3 2 FULL NAME (If deceased is a married, widowed or divorced woman, give also maiden name.) (Was deceased a U. S. War Veteran, NO [ if so specify WAR) (a) Residence. No. 36 Wave Way Avenue St. WINTHROP (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 PERSONAL AND STATISTICAL PARTICULARS 8 SEX fem. 9 COLOR OR RACE white 10 SINGLE MARRIED WIDOWED or DIVORCED (write the word) (Month) (Day) (Year) 4 I HEREBY CERTIFY, That I attended deceased from July 30 19 53 to July 30 19.53 I last saw h. Oralive on July 30, 1 9,53, death is said to (or) WIFE of Louis Adelman (Husband's name in full) 11 IF STILLBORN, enter that fact here. 12 AGE 67 Years. Months. Days If under 24 hours Hours .Minutes ANTE Due To CEDENT (b) CAUSES pulmonary artery thrombosis Due To (c) OTHER SIGNIFICANT phlebitis Major findings: Of operations. none Date of operation. Was autopsy performed? yes What test confirmed diagnosis? autopsy 5 Was disease or injury in any way related to occupation of deceased ?. no If so, specify. Nathaniel Cohen (Signed). Beth Israel Date 1953 Mt. Lebanon.W ..... Roxbury Place of Burial or Cremation July 31, 1 953 19 City or Town) DATE OF BURIAL 7 NAME OF FUNERAL DIRECTOR Benjamin Birnbach ADDRESS 10 WashingtonS t. Dor. Received and filed. AUG .... 10 .... 1953 19 (Registrar of City or Town where deceased resided) PARENTS 18 BIRTHPLACE OF FATHER (City) (State or country) RESS IA 19 MAIDEN NAME OF MOTHER Eva 20 BIRTHPLACE OF MOTHER (City) (State or country) Russia .. 21 Ethel Adelman Informant, (Address) 52 Clearway St. Boston A TRUE COPY ATTEST arles ge Inek (Registrar of City or Town where death boentre AUG. 1, 1 953 DATE FILED 19 X 73 hrs Occupation how ewife (Kind of work done during most of working life) 14 Industry or Business :. at home 15 Social Security No. 16 BIRTHPLACE (City) ....... Russ.i.a. (State or country) 17 NAME OF FATHER Gershon BAKER 13 Usual DISEASE OR CONDITION DIRECTLY LEADING bilateral confluent TO DEATH (a). bronchopneumonia INTERVAL BE- TWEEN ONSET AND DEATH have occurred on the date stated above, at 4:50Pm. 10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full) widow 3 DATE OF DEATH July 30, 1 953 [(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) No. Beth Israel Hospital Mary Adelman (Usual place of abode) MOD. TO: 7 THROP AUG10 AR 2 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 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 after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) PLACE OF DEATH Middlesex (County) Cambridge (City,or Town) Eliot Rest Home The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH Cambridge (City or town making return) 1058 164 Registered No. (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) Mary J. Davis 2 FULL NAME (If deceased] aseurgrs widowed or divorced woman, give also maiden name.) (Was deceased a U. S. War Veteran, Wintl & sperify WAR) (a) Residence. No. about (Usual place of abode) 2 St. Length of stay: In place of death .years months. days. In place of residence. ... years ... .months .. .. days. (If nonresident, give city or town and State) MEDICAL CERTIFICATE OF DEATH 3 DATE OF 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.) Cerebral thrombosis 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? no 6 Was disease or injury in any way related to occupation of deceased ?. If so, specipeter .A.Delmonico (Signed) 43 Cross St. , Belm. 7/30 53 (Addres) throp Cemetery, winthrop, Date. ...... ... 7 Place of Burial, or CremationAugust 3, 1953 (City or Town) DATE OF BURIAL 19 8 NAME OF FUNERAL DIRECTOR 147 Winthrop St., Winthrop Received and filed. LIS 6 1953 19 ... (Registrar of City pr Town where deceased resided) PERSONAL AND STATISTICAL PARTICULARS SEX Female 10 COLOR OR RACE Col 11 SINGLE MARRIED WIDOWED or DIVORCED (write the word) Widow 11a If married, widowed, or divorced HUSBAND of Lo(Give maiden name of wife in full) (or) WIFE of (Husband's name in full) 12 IF STILLBORN, enter that fact here. 75 13 AGE Years .. Days If under 24 hours Hours. Minutes 14 Usual Occupation : Kind of work done during most of working life) 15 Industry or Business: 16 Social Security No. Bridgeton Nova Scotia 17 BIRTHPLACE (City). (State or country) James T. Welch 18 NAME OF FATHER 19 BIRTHPLACE OF Bridgeton, FATHER (City) (State or country) Margaret Edison 20 MAIDEN NAME OF MOTHER 21 BIRTHPLACE OF Bridgeton MOTHER (City) N ... S. (State Buquetin) of Old Age Assistance Winthrop, Mass. 22 Informant. (Address) A TRUE COPY. ATTEST: Frederick H. Burke (Registrar of City or Town where death occurred) DATE FILED July 31, 1953 ........ .19. N.S. PARENTS no 25m-(c)-11-49-900.475 R-305 1 No. ADDRESS (Specify type of place) Housewife RECEIVE TO !! $ 1.1. 1 11-10 - THROP AUG-6 AR A R-301A 1 PLACE OF DEATH , Suffolk (County) Winthrop (City or Town) Cottage Park Yacht Club No. J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) 2 FULL NAME .. Harold Cleverly Slocomb (If deceased is a married, widowed or divorced woman, give also maiden name.) 25 Pleasant St 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 DEATH July (Month) 31 1953 (Dấy) (Year) 8 SEX Male White 9 COLOR OR RACE 10 SINGLE (write the word) MARRIED WIDOWED or DIVORCED Married 4 I HEREBY CERTIFY. That I attended deceased from L 19 52 .... to Only 30 19 10a If married, widowed, or divorced HUSBAND of .. Agnes Woodbury (Give maiden name of wife in full) (or) WIFE of. (Husband's name in full) 11 IF STILLBORN. enter that fact here. 68 12 AGE Years 7 Months 19. If under 24 hours .Hours . . Minutes ANTE Due To Hypertension CEDENT (b) CAUSES Due ANterio sclerosis. (c) OTHER SIGNIFICANT CONDITIONS Major findings: Of operations. Date of operation What test confirmed diagnosis? Was autopsy performed? Clinical 5 Was disease or injury in any way related to occupation of deceased ?. If so, specify (Signed) +1. 0 greenfield (Address) 447 Sully St wudy Datang M. D. 6 Woodlawn Crematory Everett (City or Town) Place of Burial or Cremation DATE OF BURIAL. Aug .. 3 19 5 3 Agnes Slocomb 21 Informant (Address) 25 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 If Lakes (Signature of Agent of Board of Health or other) Health Officer 8.3.53 (Official Designation) (Date of Issue of Permit) 1.12 C INTERVAL BE- TWEEN ONSET AND DEATH DISEASE OR CONDITION DIRECTLY L TO DEATH (a) Cerebral temarobage 1 year 13 Usual Claim Mangager Occupation: (Kind of work done during most of working life) 14 Industry or Business: Life Insurance Co. 15 Social Security No. 012-09-8547 16 BIRTHPLACE (City) (State or country) Kass. 17 NAME OF FATHER Elmer Slocomb PARENTS 18 BIRTHPLACE OF . FATHER (City) Unable to obtaon (State or country) 19 MAIDEN NAME OF MOTHER Bessie 20 BIRTHPLACE OF MOTHER (City) (State or country) Unable to obtain 7 NAME OF FUNERAL DIRECTOR Howard's Try not/- ADDRESS Wirting Received and filed. ...... . 1953 19 (Registrar) The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH Registered No. To be filed for buriel permit with Board of Health or its Agent. 165 PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR) (a) Residence. No. (Usual place of abode) 28 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- e death but not the disease or causing death. 50M (8)-1.51 903586 Cambridge I last saw heu alive on July 30, 1953, death is said to have occurred on the date stated above at 3:00 P.m. PERSONAL AND STATISTICAL PARTICULARS 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 deccased, 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 dicd, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or i fficer 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 imine- 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 nincteen hundred and sixteen and nincteen hundred and seventeen. G. L. Chap. 46, Scc. 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 transniit 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 Rf persons tas 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 py! 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. d undertaker or other persons shall bury a human body or the ashes thereof which Havebeen brought into the commonwealth until he has received a permit So to do front the board of health or its agent appointed to issue such permits, or it there is no such board, from the clerk of the town where the body is to be buried n' the final is to be held, or from a person appointed to have the care of the cemetery or bund found in which the interment is made. Chap. Ha, Sec. 46, G. L., (Tercentenary Edition). 6 5 RULES OF PRACTICE of the purpose of these laws calls for the observance of the follow- (1) hartice: 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 y foren of injury AUG .Bordeof 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 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 ** 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.) 1 PLACE OF DEATH Hampden (County) Monson (City or Town) The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH MONSON (City or town making return) Registered No. 166 J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) 2 FULL NAME. Gertrude A. (McCormack) Barry (If deceased is a married, widowed or divorced woman, give also maiden name.) 34 Read (Reed ) Street St. Winthrop Mass (Usual place of abode) (If nonresident, give city or town and State) Length of stay: In place of death 23 .. years. 7 months 5 days. In place of residence .7 .... years. .months. .days. MEDICAL CERTIFICATE OF DEATH PERSONAL AND STATISTICAL PARTICULARS 3 DATE OF DEATH July 16 1953 (Month) (Day) (Year) 9 SEX Female 10 COLOR OR RACE white 11 SINGLE (write the word) MARRIED widowed WIDOWED or DIVORCED 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.) Coronary Thrombosis Epilepsy 11a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full) (or) WIFE of William H. Barry (Husband's name in full) 12 IF STILLBORN, enter that fact here. 13 AGE 5.9 Years. 6 Months. 5 .. Days If under 24 hours Hours ...... Minutes 14 Usual Occupation: Housewife (Kind of work done during most of working life) 15 Industry or Business Telephone office clerk 16 Social Security No. 834 17 BIRTHPLACE (City) (State or country) Boston 18 NAME OF FATHER Austin E. McCormack 19 BIRTHPLACE OF FATHER (City) Prince Edwards (State or country) Island 20 MAIDEN NAME OF MOTHER Ansthasia Kirby 21 BIRTHPLACE OF MOTHER (City) (State or country) East .... Boston Winthrop Cemetery Winthrop Mass 7 Place of Burial, or Cremation. (City or Town) DATE OF BURIAL. July 18 153 8 NAME OF FUNERAL DIRECTOR John ............. OMaley ADDRESS 79 Atlantic, Winthrop Mass .ATTEST: (Registraf of City or Town where death occurred) Received and filed. 761.14.1153 19 (Registrar of City or Town where deceased resided) PARENTS 22 Informant Records Monson State Hosp (Address) A TRUE COPY. Henry anderson. DATE FILED July 22 1953 19 X No. (a) Residence. No. Where did Injury occur? none Manner of If so. specify of death should be transmitted on Form R-305 to the clerk of the city or town in which the deceased resided as soon as possible Injury none 5 Accident, suicide, or homicide (specify) .......... none Date and hour of injury. none 19 (City or town and State) Did injury occur in or about home, on farm. in industrial place, or in public place? none (Specify type of place) Injury none Nature of (How did injury occur?) While at work? no .Was autopsy performed? 6 Was disease or injury in any way related to occupation of deceased ?..... O .... (Signed) Benjamin Schneider M. D. (Address) Monson Mass Daduly 169 53 25m-(c)-11-49-900.475 A R-305 1 Monson .... State ... Hospital (Was deceased a U. S. War Veteran, if so specify WAR) € AUG1 & M R-302 1 PLACE OF DEATH Essex (County) Lynn (City or Town) The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH Lynn (City or town making return) Registered No. 1.67 J (If death occurred in a hospital or institution, St. \ give its NAME instead of street and number) 2 FULL NAME Bertha ... Briggs (Ruff) (If deceased is a married, widowed or divorced woman, give also maiden name.) Bartlett Rd. St. (If nonresident, give city or town and State) Length of stay: In place of death Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.