USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1953 > Part 9
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2 FULL NAME.
Mary Elizabeth Shield
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT 1
J (Was deceased a
U. S. War Veteran,
{if so specify WAR).
no
36 Coral are
With
250:12
(If nopresident, give city or town and State)
Length of stay: In place of death.
.. years.
... months ..
.......... days. In place of residence.
.years.
months.
1 days.
36
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
Female
10 COLOR OR RACE
White
11 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
(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.) Auspartenaire cardiovascular disease
and samility following fracture
of famur incum
Daccidental fall.
12 IF STILLBORN, enter that fact here.
13
AGE
81 Years
6
Months.
1
Days
If under 24 hours
.. Hours ....
Minutes
14 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
15 Industry
or Business:
At home
16 Social Security No.
None
17 BIRTHPLACE (City)
(State or country)
Mass
18 NAME OF
FATHER
Thomas McDonald
PARENTS
19 BIRTHPLACE OF
FATHER (City)
C.N .B. L.
(State or country)
England
20 MAIDEN NAME
OF MOTHER
Margaret Gagan
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Mass
7 .Old Calvary ...... Boston, .... Mas.s.o.
Place of Burial, or Cremation.
(City of Town)
DATE OF BURIAL.
Feb. 17, 1953
19
22
Joseph P .Shields
Informant.
(Address)
36 Coral Ave., Winthrop, Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter . Ballet. (Signature of Agent of Board of Health of other)
Received and filed
19
FEB 1 6 1953
(Registrar)
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Joseph P. Shields
(Husband's name in full)
Where did
Withran Masa
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
place?
Home
Manner of
Full down Ihave
Injury
Fracture of leonal
6 Was disease or injury in any way related to occupation of deceased?
M. D.
2/15 1953
Date ......
Charlestown
The altar der
2.16.53
(Official Designation)
(Date of Issue of Permit)
Married
(a) Residence.
No.
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF February
DEATH
5 Accident, suicide, or homicide (specify).
Date and hour of injury.
19
Injury occur?
(Specify type of place)
Injury
(How did injury occur?)
Nature of
Buhalt hongo
(Signed)
(Address)
25 Shattuck St
8 NAME OF
of Death. See reverse side for axtracts from the laws relativa to the return of certificates of death.
DEATH in plain terms, so that It may be properly classified under tha International Classification of Causes
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
information should be carefully supplled. MEDICAL EXAMINERS should stata CAUSE AND MANNER OF
FUNERAL DIRECTOR
Paul A. Donovan
ADDRESS
Lynn, Mass,
25M (A)-8-50-902 592
N. D. - WRITE FLINES, WITIT UNFALING DEALER INK -THIS IS A PERMANENT RECORD. Every Item of
While at work?
Was autopsy performed?
15 1953
: R-303 A 1
Registered No. ..
Mays SUPER NUKE Ny !!!
Chartedtown
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 c 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.
F t a e S d
F O re d n
se
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 untiftbete .. 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. as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931. No undertaker or other person 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., as amended.
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.
The medical examiner certifies the cause and manner of death to the best of nis knowledge and belief.
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 Ininjury, 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident.""Pistol shot wound of the chest with associated hemorrhage, hom- icidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown.''
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1)Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed).' "Heart disease, presumably coronary sclerosis. (Sudden death.)"
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
.
RANK, RATING.
ORGANIZATION AND OUTFIT
SERVICE NUMBER
1
G in ha su PE re ot re of sh a re m la p en of ap ca pe to pu th re re fo
D D R O
SI
X Suffolk (Colinty)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
32
Registered No.
[(If death occurred in a hospital or institution, St. Į 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.) 24 Timer Ppd St.
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death years. 2months.
days. In place of residence 35 years
months days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
tel. (Month)
18 1953
(Day)
(Year)
4 I HEREBY CERTIFY, Dec 15 19 52
That I attended deceased from
I last saw her alive on Lab 18 1943death is said to
have occurred on the date stated above. at
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) of Liver+ Large bowl
ANTE Due To CEDENT (b) CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings: Of operations.
Canción of color
Date of operation.
Cect.17) Was autopsy performed?
200
What test confirmed diagnosis ?.
5 Was disease or injury in any way related to occupation of deceased? If so, specify, BOMJuin M.D (Signed) (Address).
M. D.
120 19.5.3
6 Nucelach Place of Buna or Cremation
(City or Towny
DATE OF BURIAL. Stef 21
7 NAME OF FUNERAL DIRECTOR ADDRESS 210 Mmethigh Ly
Алетор
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
i
(write the word)
manual
10a If married, widowed, or divorced HUSBAND of.
(or) WIFE of.
(Give maiden name of wife in full) George & Cowen (Husband's name in full)
11 IF STILLBORN, entof that fact here.
12 AGE 54%
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Home
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No. none
16 BIRTHPLACE (City) Curt Boston (State or country)
17 NAME OF FATHER Suiteony Silva
18 BIRTHPLACE OF FATHER (City) (State or country)
Curt Bieten
19 MAIDEN NAME OF MOTHER Sarah Lec
20 BIRTHPLACE OF MOTHER (City) (State or country)
England
21 Informant (Address)
Cowerde broke
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 Agept of Board of Healthor other)
Healthe Official 2.20-53
(Official Designation) (Date of Issue of Permit)
L
R-301A 1
T.
CTIONS R RTIFICATE ving DEATH enter an one r each and (c)
s not mean dying, such e, asthenia, the discose. ions which
conditions, rise to the (o) stating in g couse
ns contrib- ath but not disease or sing death.
100M-(D)-10-48-24658
PLACE OF DEATH
2 FULL NAME
Nursing (City or Town) Mayflower Fest Home Meanslive No.J. Unn May Cowen.
(Silva)
(If nonresident, give city or town and State)
19
s&p m.
INTERVAL BE- TWEEN ONSET AND DEATH Est.
6 mos
PARENTS
Maurice W Trigly
Received and filed FEB 20 1953
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which Shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human 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 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 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
(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 fromhome when the certificate of death is needed.
KELLMedical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation. the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
PLACE OF DEATH
Suffolk (County)
R-301A 1 Winthrop T. (City or Town) 426 Revere Street
AHI 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.
Registered No.
33
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME ..
Annie S (Brodrick) Latter
(If deceased is a married, widowed or divorced woman, give also maiden name.)
426 Revere Street
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
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(Month)
(Day)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widow
4 I HEREBY CERTIFY,
That I attended deceased from
now.
1951
to.
Feb. 18
1953
I last saw her alive on.
Feb. 18
19 53 death is said to
have occurred on the date stated above, at. 10:45 P.m.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Cancer of Breast
TWEEN ONSET
AND DEATH
3 yrs.
10a If married, widowed, or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
James A Latter
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
79
Years
10
Months.
16
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.
None
16 BIRTHPLACE (City). (State of country) New Brunswick
17 NAME OF FATHER isabel M. Brodrick
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
nova Scotia
Date of operation March 1949 Was autopsy performed?
no
What test confirmed diagnosis?
Pathological ex au.
5 Was disease or injury in any way related to occupation of deceased? 200
If so, specif Dlades Liberman
(Signed)
(Address) 238 Shore Naine Wirth Date 2/18/1953
M. D.
6
Wood.Law
Crematory
Everett
Place of Burial or Cremation
DATE OF BURIAL
(City or Town)
19 53
7 NAME OF
FUNERAL DIRECTOR
Feb. 21
Howand S Sumolds
ADDRESS
Received and filed
FEB .... 201953
19
(Registrar)
PARENTS
19 MAIDEN NAME OF MOTHER Margaret C. Emery .
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
new Brunswick
21 H Mildred Latter
Informant
(Address)
426 Revere St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the Burial or transit perchit was issued: Matter of Maker (Signature of Agent of Board of Healthof thery Cheallthe officer 2/20/03
(Official Designationy (Date of Issue of Permit)
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