Town of Winthrop : Record of Deaths 1954, Part 59

Author: Winthrop (Mass.)
Publication date: 1954
Publisher:
Number of Pages: 566

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 59

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{ if so specify WAR)

TIONS R RTIFICATE

ing DEATH enter an one r each and (c)

s not mean dying, such e, asthenia .. the disease. ons which

conditions, rise to the a) stating ng

cause

s contrib- ath but not disease or sing death.

50M-3-53-909098

Boston

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 anthorized 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 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.

SPACE FOR ADDITIONAL INFORMATION

DATE OF ENTERING MILITARY SERVICE

DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER.

X Suffolk Winthrop (City or Town)

Boston 827-54

The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS (County) STANDARD CERTIFICATE OF DEATH Winthrop Community Hospital No. ... Julia a. Logan PLACE OF DEATH 2 FULL NAME

To be filed for burial permit with Board of Health or its Agent.

Registered No. 178

death occurred in a hospital or institution, the Tave its NAME instead of street and number)

PHYSICIAN - IMPORTANT

(Was deceased a

U. S. War Veteran,

if so specify WAR)

St. E. Boston Mass.

(If nonresident, give city or town and State)

Length of stay: In place of death years months.

.days. In place of residence .4.

years.

.months

.days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

aug

1954

(Month)

(Day)

(Year)

8 SEX

9 COLOR OR RACE

10 SINGLE

MARRIED

WIDOWED

or DIVORCED mal

(write the word) Single

10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full)

· (or) WIFE of

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGE

.Years

Months

Days

If under 24 hours

.. Hours

Minutes

13 Usual

Occupation :.

school-teacher(retired}

(Kind of work done during most of working life)

14 Industry

or Business:

Boston Pub. schools

15 Social Security No.

16 BIRTHPLACE (City)

St. John

(State or country) New Brunswick Can.

17 NAME OF

FATHER

John M.Logan

18 BIRTHPLACE

St. John

FATHER (City) (State or country) New Brunswick-, Can

19 MAIDEN NAME

OF MOTHER

Julia Flagg

20 BIRTHPLACE OF

MOTHER (City)

(State or country) Canada

Grand Manan

Plauenfor complex dle Salami

6 of Burial or Cremation cem

Exereten Mass DATE OF BURIAL August 26 2954 19

7 NAME OF

FUNERAL DIRECTOR ...

E. Parken.

ADDRESS.

726 Saratoga St. E . Boston

AUG 2 $ 1954 19

Received and filed

(Registrar)

PARENTS

21 Cora Hargrave (sister)

Informant.

(Address)

124 Lexington St. E. B.

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter S. Haber -

(Signature of Agent of Board of Healthor other)

8/25/54

(Official Designation) (Date of Issue of Permit)

IR-301A 1

I:TIONS FR IRTIFICATE ging C DEATH oenter tan one Ir each lond (c)

ds not mean ojlying, such le, asthenia, the disease, cons which

donditions, inrise to the e a) stating ling cause

is contrib- cuth but not hidisease or a ing death.

100M-10-53-910621

Congenital

ANTE

CEDENT (b)

CAUSES

Heart Disease

Due To (c)

OTHER

SIGNIFICANT

CONDITIONS

Major findings:

Of operations

Was autopsy performed? 2

What test confirmed diagnosis?

Date of operation.

Chicolfandgo

5 Was disease or injury in any way related to occupation of deceased?

If so, specify ......

(Signed).

M. D.

(Address)

19kg

a Datelemãa

1953

INTERVAL BE- TWEEN ONSET AND DEATH

DISEASE OR CONDITION

DIRECTLY LEADING,

TO DEATH (a) UREMIA

have occurred on the date stated above, at

6.13

.m.

...

Chia 15

to ...

Cc, 29

19.

29, 195death is said to

I last saw hon alive on

(If deceased is a married, widowed or divorced woman, give also maiden name.) 111 Trenton (a) Residence. No. (Usual place of abode)

PERSONAL AND STATISTICAL PARTICULARS

4 I HEREBY CERTIFY,

That I attended deceased from

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.

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, See. 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.

Chap. 114, Sec. 46, G. L., (Tercentenary Edition).

RULES OF PRACTICE

Thefulalhent of the purpose of these laws calls for the observance of the follow- ing rules of practice :

(H)_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.

Board of Health physicians will certify to such deaths only as those of Huskwho, 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.

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

.........

RM R-305 1

WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD

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-305 to the clerk of the city or town in which the deceased resided as soon as possible

PLACE OF DEATH

Essex

(County) Beverly

(City or Town) Beverly Hospital

The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH

Beverly

(City or town making return)

Registered No.

27979

J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)

2 FULL NAME Mildred Ethel Bennett

(If deceased is a married, widowed or divorced woman, give also maiden name.)

19 George St.

Winthrop,

St.

(If nonresident, give city or town and State)

Length of stay: In place of death .years. X X

months. days. In place of residence. ......... years.

.. months

.days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

9 SEX

10 COLOR OR RACE

11 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

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.)

Coronary Occlusion Sudden Death

12 IF STILLBORN, enter that fact here.

66 7

Months.

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.

Boston

17 BIRTHPLACE (City).

(State or country)

Mass.

18 NAME OF FATHER Hugh Evans

19 BIRTHPLACE ('

Wales

FATHER (City) (State or country)

England

20 MAIDEN NAME OF MOTHER Susan Wilder

21 BIRTHPLACE OF

Mass.

MOTHER (City)

(State or country)

Herbert Bonnett

Hingham

(Address)

Woodlawn Crematory

Place of coralfor Cremation

Everett

DATE OF BURIAL .. August 27

8 NAME OF

FUNERAL DIRECTORReynolds Funeral Home

ADDRESS Winthro Mass.

10 1954

Received and filed. 19

(Registrar of City or Town where deceased resided)

PARENTS

Informa:76 Warren St., Needham, Mass. (Address)

A TRUE COPY.

ATTEST:

(Registrar of City or Town where death occurred) Aug. 25, 1954

DATE FILED

Widowed

11a If married, widowed, or divorced

HUSBAND of.

Charles H. Bennett

(Give maiden name of wife in full)

(or) WIFE of.

(Husband's name in full)

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?

(Specify type of place)

Manner of

Injury

(How did injury occur?)

Nature of

Injury

Nö

While at work?

Was autopsy performed?

6 Was disease or injury in any way related to occupation of deceased?

If so, sp

Whitman G. Stickney

M. D

(Signed)

Beverly, Mass.

Date ..

8/24

(City or Town) 54

25m-(h)-10-48-24658

No.

(Was deceased a U. S. War Veteran, if so specify WAR) Mass.

(a) Residence. No. (Usual place of abode)

3 DATE OF

August 24, 1954

AGE

Years.

Housewife

Days

None

PLACE OF DEATH

SUFFOLK LOOUSTON

(City or Town)

The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH

OSTON

(City or town making return)

Registered No. ...

180

6871

J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)

2 FULL NAME. William Sanders

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence. No. . 34 .... Hawthorne .. Ave

St.

(If honresident, give city of 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

9 COLOR OR RACE

10 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

Married

10a If married, widowed, or divorcebose Iserow

HUSBAND of

(Give maiden

den name of wie in full)

(or) WIFE of.

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

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:

Butcher

15 Social Security No.

16 BIRTHPLACE (City).

(State or country)

Poland

17 NAME OF FATHER Abraham Sanders

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Poland

19 MAIDEN NAME

OF MOTHER

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Poland

Informant.

(Address)

Mrs Rose Sanders

A TRUE COPY

ATTEST:

{(Registrar of City or Town where death occurred)

August 12/54

DATE FILED .....

(Registrar of City or Town where deceased resided)

PARENTS

5 Was disease or injury in any way related to occupation of deceased ?. If so, specify

(Signed)

M. D.

(Address). Lahey Clinic Dos Con

8 9

Place of Burial of clematisth Israel of clinther Everett RSS

DATE OF BURIAL 19

Au ust-10/54

7 NAME OF

FUNERAL DIRECTOR

E L Levine

ADDRESS

Brookline Mass.

Received and filed.

SEP 2 0 16-1

Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD

(Usual place of abode)

3 DATE OF

DEATH

(Month)

4 I HEREBY CERTIFY.

June®

I last saw h.g

ANTE

Due To

CEDENT (b)

Due To

(c)

Major findings:

Of operations

What test confirmed diagnosis ?.

25M-3-53-909098

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,

CAUSES

artery

Aug. 9/521

(Year)

That I

attended deceased from

19 to August .9 1952 ...

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Town of Winthrop : Record of Deaths 1954, Part 59

Author: Winthrop (Mass.) Publication date: 1954 Publisher: Number of Pages: 566

Author: Winthrop (Mass.)
Publication date: 1954
Publisher:
Number of Pages: 566