USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 62
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
M R-305 1
PLACE OF DEATH
Middlesex
(County) Cambridge
(City or Town) Holy Ghost Hospital No.
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)
Registered No.
1262 199
J(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number)
Mary Leary
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
819 Shirley 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
Sept.
12.
1953
(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.)
Amoyotrophic lateral sierosis
Dysphagia Acute congestive heart failure
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?
no
.Was autopsy performed? no
6 Was disease or injury in any way related to occupation of deceased?
If so, specify Edward J. Kelley
(Signed)
M. D.
(Address) 380 Mt . Aubum St., Watertowng/121953
Holy Cross Cem. Malden
(City or Town)
DATE OF BURIAL.
8 NAME OF
FUNERAL DIRECTOR
F. J. McGlinckey
ADDRESS
583 Broadway, Chelsea
Received and filed
SEP 3 0 1953
19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
Fem.
10 COLOR OR RACE
White
11 SINGLE
(write the word)
MARRIED
WIDOWED
of DIVORCED Married
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Thomas J. Leary
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE.
57
Years
Months.
Days
If under 24 hours
Hours ........ Minutes
14 Usual
Occupation:
(Kind of work done during most of working life)
15 Industry
or Business :.
at home
16 Social Security No.
Chelsea,
17 BIRTHPLACE (City).
(State or country)
Mass
18 NAME OF
FATHER
James McInerney
19 BIRTHPLACE OF
FATHER (City).
(State or country)
Ireland
20 MAIDEN NAME
OF MOTHER
Catherine Hennessey
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
22 Informant
Thomas Leary
A TRUE COPY.
Frederich H. Buche
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Sept. 14, 1953
19
7. 5.
(Was deceased a
U. S. War Veteran,
if so specify WAR)
Winthrop
(a) Residence. No. (Usual place of abode)
3
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 25M-5-52-907046
(Specify type of place)
no
7 Place of Burial, or Sept. 15, 1953 19 (Address) 819 Shirley St, Winthrop
PARENTS
Housewife
RECEIVE
TOM
TI
RO
SEP30 AM
X
PLACE OF DEATH
Suffolk
(County)
Winthrop
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
200.
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.)
364 Winthrop Street
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.
........
.years ...
.months.
10
25
years
.. months.
.. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
September 13
Month)
(Day)
1953
(Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Widow
4 I HEREBY CERTIFY,
19.
35
Saumay 10
That I
sept. 13
19
I last saw her alive on
Dept. 13 53
death is said to
INTERVAL BE-
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Marchal Embolus
TWEEN OHSET AND DEATII 2 hrs.
11 IF STILLBORN, enter that fact here.
12
AGE
84
Years
7
16
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
At Home
15 Social Security No.
031-07-1048
Brooklyn
16 BIRTHPLACE (City).
(State or country)
New York
17 NAME OF
FATHER
Edwin Richardson
PARENTSC
18 BIRTHPLACE OF
Hillsboro
FATHER (City)
(State or country)
New Hampshire
19 MAIDEN NAME
OF MOTHER
Mary L Osborne
20 BIRTHPLACE OF
MOTHER (City)
Brooklyn
(State or country) New York
-
21 Ruth Downie
Informant
(Address)
364 Winthrop St inthron
7 NAME OF
FUNERAL DIRECTOR ...
Flaward S Jurnalel
ADDRESS
Received and filed. SEP.18 1055 19
(Registrar)
A TRUE COPY ATTEST:
Sept .. 16
1953
DATE OF BURIAL
Winthrop
(City or Town)
6 Place of Burial or Cremation
Carcinoma of descending colis
Date of operation faunay 19 Das autopsy performed.
What test co
affemed diagnos
climent + lab.
5 Was disease or injury in any way related to occupation of deceased /10
If so, specify
Jacob J. abrams
(Signed) .
(Address ) 563 ichley Jt
-M. D.
Date 9/14/53.
Winthrop/
1) 50M-(A)-11-51-905807
I R-301 1
UCTIONS OR CERTIFICATE riving OF DEATH t enter han one for each b) and (c)
does not mean dying, such ure, asthenia, > s the disease, tions which 1.
id conditions, ig rise to the (a) stating ying caus
tions contrib- death but not re disease or using death.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter G. /Safer
(Signature of Agent - board of Health or other)
H.O.
Left
15/53.
(Official Designation)
(Date of Issue of Permits
11.V
Due
Cerchal artenordenado 2 m/s
ANTE
CEDENT (b)
CAUSES
IGeneralized
artenoodlesbus
4 yrs.
OTHER
SIGNIFICANT
CONDITIONS
Osteoporosis
1 year
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Thomas W Johnson
have occurred on the date stated above, at.
5:30 A
. . m.
attended deceased from
to ..
days. In place of residence.
(City or town making return)
(City or Town) Winthrop Community Hospital No.
Willette ( Richardson) Johnson
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
(Usual place of abode)
(write the word)
Months.
Days
Major findings:
Of operations.
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 seven- teen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and tbe 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 only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; ... General Laws, Chap. 38, Sec. 6.
No undertaker or other persons shall bury a human body or the asbes 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 following 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 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 occupa- tion, 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 tbe kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at bome. 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
A R-301A 1
PLACE OF DEATH
× Sufach. (County)
PESTE 20 10/3/03
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.
201
2 FULL NAME.
Baby (bay) Chanbacca
(If deceased is a married, widowed or divorced woman, give also maiden name.) 1116 UMSite HV.
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death .. years months. days. In place of residence
78
. years.
months.
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
Sept
14,
1453
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Sept 14.
1953.
to.
1953
I last saw
hinnalive on
19.
death is said to
have occurred on the date stated above, at 12:42 pm.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here, Stell-Jam.
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)
17 NAME OF
FATHER
mario combacia
18 BIRTHPLACE OF FATHER (City) (State or country)
Baston
19 MAIDEN NAME OF MOTHER Esta De Luca
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Baston
21 Informant: Maria Gianharca (Address)
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Wattent. Baker
I.O.
(Signature of Agent of Board of Health or other) Vest 1875-3.
(Official Designation)
(Date of Issue of Permit)
X
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, ications which th.
id conditions, ing rise to the se (a) stating rlying cause
itions contrib- e death but not the disease or causing death.
50M-5-52-907046
7 NAME OF
FUNERAL DIRECTOR
ADDRESS 9philips
Received and filed.
SEP 18-1953
19
(Registrar)
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
bangle
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)
Stillborn
ANTE
CEDENT (b)
CAUSES
Prematuros
Due To (c) Placenta Previa
OTHER
SIGNIFICANT
CONDITIONS
Herbal-
Placenta Proverificando
Major findings:
Of operations
CREDURERI
(Calsaucan Deliver)
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).
(Address) 186 PriceLa Ct Date 9/4-20
M. D.
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL. Jeff. 18-153 19
Menthub. (City or Town)
Cash.
¿(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)
E. Boston
St.
(If nonresident, give city or town and State)
(write the word)
Registered No.
Muchop- mak
PARENTS
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 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 seventecn. 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.
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- 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 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.
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