Town of Winthrop : Record of Deaths 1954, Part 68

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

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September 30

19.54

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permut was issued: Wolter A. Habees-

(Signature of Agent of Board of Health or other)

Health fever

9/28/54

(Official Designation)

(Date of Issue of Permit)

C .

R-301A 1

TIONS R RTIFICATE ing DEATH enter an one 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 ing death.

100M-10-53-910621

3 DATE OF

DEATH

4 I HEREBY CERTIFY.

September 27

Registered No.

Tuscaroro

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 cleceased, 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.

RECEIVE

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 frota the clerk of the town where the body is to be buried or the funeral is to be held før from a person appointed to have the care of the cemetery or burial ground ut which the interment is made.

Chapa 14 8:40, 0. A. (Tercentenary Edition).

2 CA OFFER MIN RULES OF PRACTICE

The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of? Brice:

(1) Attending physicians will certify to such deaths only as those of persons to whom. the ven Dedorde care during a last illness from disease unrelated to any form of>

(2) Board offaith 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) PriorSxeminers 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-301A 1

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

Registered No.

J(If death occurred in a hospital or institution,

St. Į give its NAME instead of street and number) No.

2 FULL NAME.

Ethel Frances Dean

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

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

20 Sargent .Street

St.

(If nonresident, give city or town and State)

Length of stay: In place of death .. years months 1 hour In place of residence 6.3 .years .months .days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

Female

White

9 COLOR OR RACE

10 SINGLE

(write the word)

Single

WIDOWED

or DIVORCED

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.

7.3 Years 2.

Months

Days

If under 24 hours

Hours ... . Minutes

13 Usual

Occupation :

Housekeeper

14 Industry

or Business:

Own home

15 Social Security No ....

nọ

16 BIRTHPLACE (City)

(State or country)

Mass.

17 NAME OF

Alvan Hall Dean

18 BIRTHPLACE OF

FATHER (City)

· Medford

(State or country)

Mass.

19 MAIDEN NAME

OF MOTHER

Sarah Webber

20 BIRTHPLACE OF

MOTHER (City)

Hollowell

(State or country)

Maine

21 Miss Gladys A. Dean

Informant

(Address)

20 sargent St.

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was Issued:

Watter & Baker

(Signature of Agent of Board of Health or other) A.Q.

att Oct 1/54,

(Official Designation)

(Date of Issue of Permit)

UCTIONS FOR CERTIFICATE

giving OF DEATH t enter than one for each b) and (c)

does not mean f dying, such ure, asthenia, ns the disease. ations which h.

conditions, ng rise to the : (a) stating lying cause

ions contrib- death but not e disease or using death.

50M (8)-1-51 903586

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

If so, specify,

hun 7 Celin net

M. D.

(Address) Never Maps Date 2955211954

(Signed)

Winthrop

. Winthropcemetery

Place of Burial or Cremation

(XCity or Town)

DATE OF BURIAL

7 NAME OF

FUNERAL DIRECTORY

ADDRESS

174 Winthrop St.

1954

Received and filed

(Day)

4 I HEREBY CERTIFY,

That I attended deceased from Sept. 29, 54

Sept 29

1954

I last saw h.

.alive on.

7.10 PM

death is said to

have occurred on the date stated above, at m.

DISEASE OR CONDITION Natural Causes DIRECTLY LEADSYonary Thrombosis TO DEATH (a)

INTERVAL BE- TWEEN ONSET AND DEATH 3Hrs

ANTE

CEDENT (b)

CAUSES

Arteriosclerosis

Due To

Generalized

Years

Due To (c)

OTHER SIGNIFICANT CONDITIONS

Major findings:

Of operations

NONE

Date of operation

Was autopsy performed?

What test confirmed diagnosis?

Oktober

1954

Wilfred B. Marsk

(Registrar)

Winthrop Community Hospital

To be filed for burial permit with Board of Health or its Agent. 203

PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)

3 DATE OF

DEATH

September

29.

1954

(Year)

(Month)

19 Sept 29 1954

(Kind of work done during most of working life)

Chelsea

PARENTS

1. 5.

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- tcen, 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 inme- 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.

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 elerk 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 inanner 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 broughthim 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 te hahen or from a person appointed to have the care of the cemetery or burnt ground nywinch the interment is made.

Chap, IN 19 (Tercentenary Edition).

EFICE

ROLES OF PRACTICE

The fulaun cht of the 9 rpossofthese 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 (2) Board o Health physicians will certify to such deaths only as those of persons who. by 'recognized disease unrelated to any form of injury, have died withof frecent medical attendance or whose physician is absent from home when the cert incute 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 ing Asulting somticemia), and by the action of chemical (drugs or pois thermal or electridi 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 oceupation 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, eook-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)

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 burlal permit with.Board of Health or its Agent.

(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) No. Thomas A. . White 2 FULL NAME.

(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) WW .... 2

(a) Residence. No. 105 Johnson Avenue ,Winthrop (Usual place of abode)

St.

(If nonresident, give city or town and State)

Length of stay: In place of death 10years. .. months. days. In place of residence 1.O .. years .. .months .. days.

MEDICAL CERTIFICATE OF DEATH

PERSONAL AND STATISTICAL PARTICULARS

3 DATE OF

DEATH

September 30

(Day)

(Month)

1954

(Year)

8 SEX

Male

9 COLOR OR RACE

White

10 SINGLE

MARRIED

WIDOWED

or DIVORCEDMarried

4 LHEREBY CERTIFY,

Jestr8

19 64

Sept. 30

That I attended deceased from

1937

I last saw him alive on Sept 30, 199 Y death is said to

have occurred on the date stated above, at ... Est 59.m.

INTERVAL BE- TWEEN ONSET AND DEATH

11 IF STILLBORN. enter that fact here.

Suder

PAGE 48 Years

Months 19 Days

If under 24 hours

Hours .. ... Minutes

13 Usual

Occupation:

Attorney

(Kind of work done during most of working life)

14 Industry

or Business:

Employers Group

15 Social Security No.

015-07-8959

16 BIRTHPLACE (City) ..

(State or country)

Mass.

17 NAME OF

FATHER

John P. White

PARENTS

18 BIRTHPLACE OF

FATHER (City)

Lincoln

(State or country)

Mass.

19 MAIDEN NAME

OF MOTHER

Mary G. Harvey

20 BIRTHPLACE OF

MOTHER (City)

Waltham

(State or country)

Mass.

21 Mrs ....... Margery White-wife

(Address)

105 Johnson Ave.Winthrop

7 NAME OF

FUNERAL DIRECTOR:

Richard C. Kirby

ADDE

917 Bennington St. E. Boston

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit pef mit was issued: Walter 6. Baker

(Signature of Agent of board of Health or other)

oct 1-1954

(Official Designation)

(Date of Issue of Permit)

10a If married, widowed, or divorced

HUSBAND of.

Margery Westcott

(Give maiden name of wife in fuli)

(or) WIFE of

(Husband's name in full)

DISEASE OR CONDITION

DIRECTLY LEADING

TO DEATH (a)

Coronary Thrombosis

ANTE

Due To

CEDENT (b)

CAUSES

Due To

(c)

OTHER

SIGNIFICANT

CONDITIONS

Major findings:

Of operations.

none

Date of operation

none Was autopsy performed?

What test confirmed diagnosis ?.

Clinical Signs

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

If so, specify .....

(Signed)

Daniel J. OBriese0/20,19%

M. D.

(Address)

Winthrop

Date. ...

6 Winthrop Cemetery Winthrop

Place of Burial or Cremation

(City or Town)

DATE OF BURIAL

October 4th

Received and filed. OCT A 1954 19

(Registrar)

100M-10-53-910621

R-301A 1

TIONS R RTIFICATE ing DEATH enter an one reach and (c)

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

conditions. rise to the a) stating ng cause

s contrib- ath but not disease or ing death.

105 Johnson Avenue, Winthrop

204

Registered No.

Waltham

(write the word)

EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and' shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventecn. G. L. Chap. 46, Sec. 10.

No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be. a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the

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Town of Winthrop : Record of Deaths 1954, Part 68

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

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