USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 72
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INTERVAL BE- TWEEN ONSET ANO DEATH
11 IF STILLBORN, enter that fact here.
12
AGE .......?... Years.1.
Months.
26 Days
If under 24 hours
.Hours ....... Minutes
13 Usual
Occupation:
SRG& WE done during most of working life)
14 Industry
or Business:
Grammar school
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
Boston
ass.
17 NAME OF
FATHER
George L Woy
18 BIRTHPLACE OF
FATHER (City).
wristol
(State or country)
Conn
19 MAIDEN NAME
OF MOTHER
Jane O Ganirons
20 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country)
Mass
21
Informant
(Address}
O Wey
A TRUE COPY
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Oct 26
19
53
(Registrar of City or Town where deceased resided)
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED Single
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) ... Intracranial hemorrhage
ANTE CEDENT (b) CAUSES
Due To
.....
Thrombocytopenia
3mos
Due To (c) Lymphatic ..... loukomia .....
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations.
Date of operation .Was autopsy performed?
What test confirmed diagnosis ?.
bone .... marrow autopsy
5 Was disease or injury in any way related to occupation of deceased ?....... If so, specify. (Signed) ........... Penn
M. D.
(Address). 20 Ash St
Date.1.02.3
6 Woodlawn Com
Place of Burial or Cremation
DATE OF BURIAL
Oct 26
19
53
7 NAME OF
FUNERAL DIRECTOR
A ... Marsh
ADDRESS
nthrop,
19
PARENTS
Everett
(City or Town)
Received and filed.
X
A R-302 1
MEDICAL CERTIFICATE OF DEATH
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(write the word)
That I attended deceased from
-3hr
F TO !!!
if (1)
Ur
0:
28
6
0
NOV-3 AM
R-301A T.
1
PLACE OF DEATH
Suffolk (County)
Winthrop2.
(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.
232
Winthrop Community Hospital No.
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME. Esther M (Bellingham) Gillies
(If deceased is a married, widowed or divorced woman, give also maiden name.)
51 Birch Rd.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years. .months .days. In place of residence. .. years 12 .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October (Month)
25
1953. (Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED,'idOW
4 &HEREBY CERTIFY.
March15 1949.
to ..
October 25
...
1953
I last saw h
er alive on
October 24, 25, death is said to
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
James Gillies
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 83
Years
5
Months
13
.Days
If under 24 hours
Hours
Minutes
13 Usual
House wife
Occupation :
(Kind of work done during most of working life)
14 Industry
or Business:
Own Home
15 Social Security No.
16 BIRTHPLACE (City).
St. John
(State or country) New Brunswick
17 NAME OF
FATHER
John Bellin ham
18 BIRTHPLACE OF
FATHER (City)
(State or country)
England
19 MAIDEN NAME
OF MOTHER
Rebecca Wilmot
20 BIRTHPLACE OF MOTHER (City) (State or country) Canada
21 Informant James H Gillies
(Address) 59 Magazine St. Cambridge
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Walter & thakers.
(Signature of Agent of Board of Health or other)
Healthe Officer 10.27.53
(Official Designation) VV
(Date of Issue of Permit)
50M-5-52-907046
7 NAME OF FUNERAL DIRECTOR. Winthrop mais
ADDRESS
Received and filed OCT 28 1953 et. 28 1953
(Registrar)
4 years
6 years
Due To (c)
OTHER
Diabetes Mellitus
SIGNIFICANT
CONDITIONS
arterial embanktheo
Major findings:
Of operations.
none
Date of operation
Was autopsy performed ?.
What test confirmed diagnosis ?.
Clinical Laboratory
5 Was disease or injury in any way related to occupation of deceased? 0. If so, spegify ...
(Signed) Maurice TranneE
(Address) 62 Charley JOS Wiak
M. D.
6 winthrop
winthrop (City or Town)
Place of Burial or Cremation
DATE OF BURIAL
Oct. 28
19.5}
Naward S Reynolds
MIS
UCTIONS OR CERTIFICATE iving OF DEATH t enter han one For each b) and (c)
oes not mean f dying, such ure, asthenia. is the disease. ations which h.
conditions. g rise to the (a) stating ying cause
ons contrib- death but not e disease or using death.
6 day
PARENTS
INTERVAL BE- TWEEN ONSET AND DEATH
have occurred on the date stated above, at 3: 15 A.m.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a) Centurioncheati+
Ry Ratensive heart disease
Generalized antico-
ANTE
CEDENT (b)
CAUSES
Selbasis
(Dayy
That
I attended deceased from
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify WAR)
(a) Residence.
No.
(Usual place of abode)
35
Registered No.
(write the word)
uone
2 - R
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical nfficer 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 nf the deceased, his supposed age, the disease of which he died, defined as required by section nne, 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 tn 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 he 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 nr 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 eaused 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
R-301A 1
PLACE OF DEATH ...
Sufferk (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. 233
Wheretherop Community Hospital St. ( give its NAME instead of street and number) No. .
Baby Boy Martinez 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also-maiden name.)
Washington Terrace St.
(If nonresident, give city or town and State)
/ .... months days. In place of residence. .years .. months .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
at
25
(Month)
(Day)
1953 (Year)
8 SEX
Male
9 COLOR OR RACE
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
·single
4 I HEREBY CERTIFY,
19
to
19
I last saw h
alive on
19
death is said to
have occurred on the date stated above, at.
6:16 m.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH Salling Machiavel Plus
ANTE
Due To
MACERAted
CEDENT (b) CAUSES (while
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation
„Was autopsy performed ?.
What test confirmed diagnosis ?.
Clin-
-
Wirthut Den (Verthrity
6 Place of Burial or Cremation (City of Town)
DATE OF BURIAL
Get 26.
195
7 NAME OF
FUNERAL DIRECTOR
Cheful 3 March
ADDRESS
Received and filed. OCT 2.7.1953 .19
(Registrar)
28kl WKS
13 Usual
Occupation :
(Kind of work done during most of working life)
PREGNANTY 14 Industry or Business:
15 Social Security No. Winthrop
16 BIRTHPLACE (City). (State or country)
must
17 NAME OF
FATHER
Jeux Martinez
18 BIRTHPLACE OF
East Boston
FATHER (City)
(State or country)
mars
19 MAIDEN NAME
OF MOTHER
Barbara Cropforel
20 BIRTHPLACE OF MOTHER (City) (State or country)
21 Informant Eugene Martinez
(Address)
/ Wachung thiserad
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter Soithaker
(Signature of Agent of Board of Health or other)
10.26.53
(Official Designation) (Date of Issue of Permit)
ICTIONS OR ERTIFICATE
iving F DEATH enter han one or each ) and (c)
Does not mean dying, such re, asthenia, s the disease. tions which
conditions. g rise to the (a) stating ving cause
ons contrib- eath but not disease or using death.
SOM-5-52-907046
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
11 Japan 412 Date 10/25
19
(Address)
...
M. D.
1
J(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR) 120
(a) Residence. No.
(Usual place of abode)
Length of stay: In place of death
.years.
That I
attended deceased from
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
INTERVAL BE- TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.
12
AGE 0 Years
0
Months ..
.C ..... Days
If under 24 hours
Hours ......
.. Minutes
PARENTS
PERSONAL AND STATISTICAL PARTICULARS
Registered No.
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 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 hoard, 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 he 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 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
R-301 1
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town) 10 Hichland Ave. No.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return)
234
Registered No.
j(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
Martha Ann (Baxter) Hayden
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 10 Highland
Ave
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years. .months .. ...... .. days. In place of residence.
66 years
..... months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
October
DEATH
(Month)
(Day)
27
1953
(Year)
8 SEX
Female
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
widow
4 I HEREBY CERTIFY.
May 16
53
to.
October 27
19.53
I last saw her
alive on
October 27, 1955, death is said to
have occurred on the date stated above, at 7:20 P. m.
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Nelson E Hayden
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
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