USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 6
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Manque W Tuby
ADDRESS
WAX 27 1954 19
Received and filed
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE
glück
10 SINGLE (write the word) MARRIED WIDOWED or DIVORCED wired Michael
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12 AGE 75 Years
Months
Days
If under 24 hours Hours Minutes
13 Usual Occupation :.
Lahuman (Kind of work done during most of working life)
14 Industry or Business :.
15 Social Security No ..
Randolph Mass
17 NAME OF FATHER
e
18 BIRTHPLACE OF FATHER (City) (State or country)
Vermont
عنك
19 MAIDEN NAME OF MOTHER
Margaret Babwell
20 BIRTHPLACE OF MOTHER (City) (State or country)
Rey ny.
Mais Clara Bow
....
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health or other) Alattto affecto 1.17.54
(Official Designation)
(Date of Issue of Permit)
1
m.s.
R-301A 1
CTIONS R RTIFICATE
ving DEATH enter an one r each and (c)
es not mean dying, such re, asthenia, the disease. ions which
conditions, rise to the (a) stating ing cause
ns contrib- ath but not disease or sing death.
100M-(D)-10-46-24656
21 Informant (Address) 175 Thestud Une Putting
Biensull
PARENTS
16 BIRTHPLACE (City) .. (State or country)
+ years
10a If married, widowed, or divorced HUSBAND of
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. (Usual place of abode)
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.
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) 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
PLACE OF DEATH
Suffolk (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.
19
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME ..
Anna E. McGuigan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No.
120 Banks Street
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
.....
years.
months.
days. In place of residence.
2
... years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
White
9 COLOR OR RACE
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED dowed
4 I HEREBY CERTIFY,
That I attended deceased from
52
to ..
Jan. 27
19
34
augs,
...
I last saw her alive on
Jan 27, 1954, death is said to
have occurred on the date stated above, at 7.30 Pm.
INTERVAL BE-
DISEASE OR CONDITION, CIRRHOSIS
DIRECTLY LEADI
TO DEATH (a)
Cincorio 1 Siber
TWEEN ONSET
AND DEATH
2 yrs
11 IF STILLBORN, enter that fact here.
63
12
AGE
Years
Months
Days
If under 24 hours
.. Hours ... ... Minutes
13 Usual
Occupation:
School Teacher
(Kind of work done during most of working life)
14 Industry
or Business:
Schools
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
Mass
17 NAME OF
FATHER
Frank E. Shields
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mass
19 MAIDEN NAME
OF MOTHER
Mary A. Walsh
(State or country)
Mass
21
Informant
(Address)
120 Banks St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter I to akers. (Signature of Agent of Board of Health or other)
Thatthe Piece (Official Designation)
(Date of Issue of Permit)
UCTIONS OR CERTIFICATE
iving OF DEATH t enter han one For each b) and (c)
oes not mean f dying, such ure, asthenia, s the disease. ations which h.
conditions, g rise to the (a) staling ying
ons contrib- death but not e disease or using death.
Major findings:
Of operations.
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 n. Carlam
(Signed).
M. D.
(Address) 186 Princeton st CB. Date 1-28-
1954
20 BIRTHPLACE OF
MOTHER (City)
Boston
6 Calvary
Boston Mass
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
January 30
195.4.
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop Mass.
Received and filed.
MAX 23 1964
19
(Registrar)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Bernard .. J. ... McGuigan
(Husband's name in full)
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
ascites - malnututos
SIGNIFICANT
CONDITIONS
50M-3-53-909098
R-301A 1
No.
120 Banks Street
3 DATE OF
DEATH
January 27 1954
(Month)
(Day)
(Year)
Registered No.
Mrs. Joseph Deveraux
1.29.54
East 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 eath of a person whom he has attended during his last illness, at the request fan undertaker or other authorized person or of any member of the family of e deceased, furnish for registration a standard certificate of death, stating to the est of his knowledge and belief the name of the deceased, his supposed age, the sease of which he died. defined as required by section one, where same was ontracted, the duration of his last illness, when last seen alive by the physician 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 receding section or by section forty-five of chapter one hundred and four- en, shall, if the deceased, to the best of his knowledge and belief, served in the my, navy or marine corps of the United States in any war in which it has been gaged. insert in the certificate a recital to that effect, specifying the war, and iall also certify in such certificate both the primary and the secondary or imme- ate cause of death as nearly as he can state the same. For neglect to comply : ith any provision of this section, such physician or officer, shall forfeit ten dollars. or the purposes of this section and of sections forty-five, forty-six and forty-seven `said chapter one hundred and fourteen, the word "war" shall include the China lief expedition and the Philippine insurrection, which shall. for said purposes; be emed to have taken place between February fourteenth, eighteen hundred and nety-eight and July fourth, nineteen hundred and two, and the Mexican border. rvice of nineteen hundred and sixteen and nineteen hundred and seventeen. . 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 he 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, Ģ. 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, See. 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 hody is to be buried or the funeral is to he 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 -from home when the certificate of death is needed.
No undertaker or other person shall bury or otherwise dispose of a human body., a town, or remove therefrom a human body which has not been buried, untilhe' as received a permit from the board of health, or its agent appointed to, issue (> injury, have died without recent medical attendance or whose physician is absent ch permits, or if there is no such board, from the clerk of the town where the erson died; and no undertaker or other person shall exhume a human body 'and (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. move it from a town, from one cemetery to another. or from one grave or tomb her than the receiving tomb to another in the same cemetery, until he has ceived a permit from the board of health or its agent aforesaid or from the clerk the town where the body is buried. No such permit shall be issued until there all have been delivered to such board, agent or clerk, as the case may be. satisfactory written statement containing the facts required by law to be turned and recorded, which shall be accompanied, in case of an original inter- ent, by a satisfactory certificate of the attending physician, if any, as required by Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death. w, or in lieu thereof a certificate as hereinafter provided. If there is no attending ysician, or if, for sufficient reasons, his certificate cannot be obtained early ough for the purpose, or is insufficient, a physician who is a member of the board health, or employed by it or by the selectmen for the purpose, shall upon 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. plication make the certificate required of the attending physician. If death is used by violence, the medical examiner shall make such certificate. If such a ermit for the removal of a human body, not previously interred, from one town another within the commonwealth cannot be obtained early enough for the urpose, the certificate of death made as above provided and in the possession of e undertaker desiring to make such removal shall constitute a permit for such moval; provided, that such body shall be returned to the town from which it was moved within thirty-six hours after such removal, unless a permit in the usual rm for the removal of such body has been sooner obtained hereunder. If the
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
A R-303 A 1
PLACE OF DEATH
Suffolk
County)
Winthrop
(City or Towh) Winthrop St. No. 120
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial pormit with Board of Health or its Agent.
Registered No. .......
.....
20
J(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).
(If nonresident, give city or town and State)
Length of stay: In place of death ............ years ...
.. months ............ days. In place of residence.
2 ..... years.
.months.
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
femal
10 COLOR OR RACE
white
11 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
married
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
frank J. Sheeran
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
AGE 1 0 Years
Months.
.Days
If under 24 hours
.Hours ..
Minutes
14 Usual
Occupation:
supervisor
(Kind of work done during most of working life)
15 Industry
or Business:
John Hancock Lefe Ins. Co.
16 Social Security No ..
030-20-7871
17 BIRTHPLACE (City).
(State or country)
Peabody Mass.
18 NAME OF
FATHER
John E. Hayes
19 BIRTHPLACE OF
FATHER (City).
(State or country)
Peabody wass.
20 MAIDEN NAME
OF MOTHER
Margaret A. Haves
Kirby
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Danvers mass.
1
25M-1-52-906135
(a) Residence.
No.
(Usual place of abode)
3 DATE OF
DEATH
5 Accident, suicide, or homicide (specify).
Injury
Manner of Ccidental
How did injury occur?)
Nature of
Injury
(Signed)
7
St. Marys
Place of Burial, or Cremation.
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
place?
Home
(Specify type of place)
27 1954
ZI (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.)
Cardiac
arrest following
blunt injury of hlad incrivel
٨٠
accidentthe fall
Date and hour of injury
Jan 22 1954
Where did
Injury occur ?.
Winthrop
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public
fall down
While at work? .Was autopsy performed? yes
6 Was disease or injury in any way related to occupation of deceased? If so, specie
M. D.
(Address). 25 Shathat It Date/2.8 1054
Danvers
(City or Town)
DATE OF BURIAL
Feb. 1.1954
19
22
Informant Mirs. J. Vincent Murray
(Address)
nevere Pass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Watter . Bakkers
(Signature of Agent of Board of Health of other)
Thatthe
9-1.54
(Official Designation)
(Date of Issue of Permit)
Every item of
N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD.
of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
2 FULL NAME.
Mildred H. Sheeran
(If deceased is a married, widowed or divorced woman, give also maiden name.)
120 Winthrop St Worth
8 NAME OF
FUNERAL DIRECTOR
J ... Vincent Murray.
ADDRESS. hevere Haga
Received and filed. 19
(Registrar)
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 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 imine- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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