USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 74
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PERSONAL AND STATISTICAL PARTICULARS
8 SEX F
9 COLOR OR RACE
White.
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
.
Widow
4 I HEREBY CERTIFY.
That I attended deceased from
OCTOBER 17 1954
to ..
OCTOBER17
19
I last saw
hA .. alive on.
OCTOBER( I) 19 5 death is said to
have occurred on the date stated above, at
11:550:4
INTERVAL BE- TWEEN ONSET AND DEATH 14hrs
11 IF STILLBORN, enter that fact here.
12
AGES
Years
7
.Months 3.
Days
If under 24 hours
Hours
Minutesª
13 Usual
Fancy Candy Packer
(Kind of work done during most of working life)
Occupation :
14 Industry
or Business:
Baileys Candy Factory
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
mass
17 NAME OF
FATHER
Antoine Thomas
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Not Known
(State or country)
Portugal
19 MAIDEN NAME
OF MOTHER
Mary Goulart
20 BIRTHPLACE OF
MOTHER (City)
Not Known
(State or country)
Portugal
21 Informant (Address)
68 Waverly St. Arlington Wass,
I HEREBY CERTIFY that a satisfactory standard certincate of death was filed with me BEFORE the burial or transit permit was issued: Walter M. Haberg (Signature of Ages of Board of Health or other)
Thealt, Spices
Official Designation)
10/19 /5/
(Date of Issue of Permit)
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such ilure, asthenia, ans the disease. cations which th.
id conditions. ing rise to the e (a) stating rlying cause
tions contrib- e death but not the disease or causing death.
50M-2-49-25666
5 Was disease or injury in any way related to occupation of deceased? 20
faut abramo 2.9
M. D.
(Signed)
856 2 Plumley St. 100kg10/18/54
6 Winthrop Cemetery
Place of Burial or Gromation
Winthrop
(City of Town)
DATE OF BURIAL
October 21
1954
7 NAME OF
FUNERAL DIRECTOR
David Malcolm
ADDRESS
743
Main St. Reading
CIGT 60 1954
19
Received and filed
(Registrar)
10a If married, widowed, or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
James J.
Sheerin
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEAD
CEREBRAL
TO DEATH (a)
HEMORRHAGE
ANTE
Due To
CEDENT (b)
CAUSES
Hypertension
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
none
Date of operation
Was autopsy performed?
What test confirmed diagnos
CLINICAL
6 mos
DEATH
3 DATE OF OCTOBER
17
1954
(Month)
(Day)
(Year)
Winthrop Community Hospitals
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran.
if so specify L'AR),
(If nonresident, give city or town and State)
Boston
Anne Steek
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 safte was = Mstyled by recognizable disease, or when any person is found dead. 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 for- 1.2 if there'is 'no such board, from the clerk of the town where the body is to be buried of the funeral is to be held, or from a person appointed to have the care of the cemetery of burial ground in which the interment is made. 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 way in which it has beenla) engaged, insert in the certificate a recital to that effect, specifying the far the shall also certify in such certificate both the primary and the secondary or infme- Chap. 114, Sec.46, G. L., (Tercentenary Edition). diate cause of death as nearly as he can state the same. For neglect tocomply .. 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 RULES OF PRACTICE 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 Both!" The fulfillment of the purpose of these laws calls for the observance of the follow- deemed to have taken place between February fourteenth, eighteen hunfter and ingt Attending physicians will certify to such deaths only as those of persons es of practice : ninety-eight and July fourth, nineteen hundred and two, and the Mexicangy service of nineteen hundred and sixteen and nineteen hundred and seventeen to whom they have given bedside care during a last illness from disease unrelated any form of injury.
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 has received a permit from the board of health, or its agent appointed 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 shallexhume 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 nade 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 dicd by violence. or by the action of chemical, thermal or ele trical agents or following abortion, or from diseases sulting from injury or infection relating to occupation, or suddenly when not - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
TOlaSo 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 o'do from the board of health or its agent appointed to issue such permits, or
(2) Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, haredied without recent medical attendance or whose physician is absent Ott Orom homenthen 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
Registered No.
2:22
2 FULL NAME Anthony.E ..... Teixeira
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 49 Circuit Road Winthrop St.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ..?... years. months .days. In place of residence. 17years .. months .. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
October
18
1954
(Year)
(Month)
(Day)
8 SEX
male
9 COLOR OR RACE
white
(write the word)
10 SINGLE
MARRIED
WIDOWED
or DIVORCED married
4 hHEREBY CERTIFY.
19.
54
June 22
That I attended deceased from
to.
October 18.
1954
last saw h UM alive on.
October 17, 1954, death is said to
have occurred on the date stated above, at 12 noon m. INTERVAL BE- TWEEN ONSET AND DEATH 5 days
ANTE
Due To Carcinoma of
CEDENT (b)
CAUSES
Stomach
3 yrs
Due To
(c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Carcinoma of stomach
Date of operation Aug. 1953 Was autopsy performed?
no
What test confirmed diagnosis ?.
Operation
5 Was disease or injury in any way related to occupation of deceased? no
Erthur@munaym.
(Signed).
(Address) Winthrop Mass Date 19 Oct. 1954
... M. D.
Winthrop
Winthrop
6 Place of Burial or Cremation (City or Town)
DATE OF BURIAL
October 21 1954
19
7 NAME OF
FUNERAL DIRECTOR .... Richard C .Kirby
ADDRESS.
917 Bennington St East Boston
OCT ZO 1954
19
Received and filed
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Portugal
19 MAIDEN NAME
OF MOTHER
Philomena Pimentel
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Portugal
21
Mrs.Agnes C .Teixeira
(Address) 49 Circuit Rd Winthrop
...... wife
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 Agent of Board of Health or other)
Thealite Nice
10/2015K
(Official Designation)
(Date of Issue of Peymit)
If under 24 hours
.Hours
Minutes
13 Usual
Occupation :.
Phone Installer
(Kind of w k done during most of working life)
Telephone"
14 Industry
or Business:
New England Telegraph ... Co
15 Social Security No.
011-07-4051
Boston
16 BIRTHPLACE (City) ..
(State or country)
Massachusetts
17 NAME OF
FATHER
Henrique Teixeira
100M-10-53-910621
R-301A 1
UCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each b) and (c)
does not mean of dying, such lure, asthenia, ns the disease, ations which .h.
d conditions. ng rise to the e (a) stating lying cause
ions contrib- death but not he disease or ausing death.
M.s.
No.
49 Circuit Road Winthrop
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) no
10a If married, widowed, or divorced
HUSBAND of
gnes C. Smiddy
(Give maiden name of wife in full)
(or) WIFE of ..
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
Bronchopneumonia
11 IF STILLBORN, enter that fact here.
12
AGE . 69 Years
4
Months
5 Days
To be filed for burlal permit with Board of Health or its Agent.
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 hy 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 TherlafarloV 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 Haard, from the derk of the town where the body is to be buried or the aneral held, or from a person appointed to have the care of the und in which the interment is made.
cemeter Châu SAC. O.G. L., (Tercentenary Edition).
FFICE
.2
RULES OF PRACTICE
be
NIW
fillment of thepurpose of these laws calls for the observance of the follow-
ing h1
practice:
ding physicians will certify to such deaths only as those of persons
ve edside care during a last illness from disease unrelated to wh
to a
h physicians will certify to such deathsonly as those of persons injury, have died disabled by recognized disease unrelated to any form of hout 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 not only deaths caused directly or indirectly by
traun
OCT20
These inclth
ling 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
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.
223
2 FULL NAME .. Esther Margaret (Davis) Floyd (If deceased is a married, widowed or divorced woman, give also maiden name.)
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)
(a) Residence. No. 50 Adams Street (Usual place of abode)
St.
35
days.
In place of residence
years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED-
Married
4 I HEREBY CERTIFY.
That I attended deceased from
APRIL 23,
1951
to
OCTOBER 23
1954
I last saw h ER .... alive on.
OCTOBER 23, 1954, death is said to
have occurred on the date stated above, at 10:40 P.m.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
Years
Months
5
.Days
If under 24 hours
Hours .. ... Minutes
13 Usual
Housewife
Occupation :.
(Kind of work done during most of working life)
14 Industry
or Business:
Own home (2-201->71
15 Social Security No. 028-207-871
Newbury
16 BIRTHPLACE (City)
(State or country)
Vermont
17 NAME OF FATHER Hilers D Davis
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Cormithr-Comint.fr Vermont
19 MAIDEN NAME OF MOTHER
Charlotte Crehore
20 BIRTHPLACE OF
Sandover Sandoval
Illinois
21 Informant (Address) 58-xaany Stfloyd Withrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or, transit permit was issued: Walter & Makers. (Signature of Agent of Board of Health or other)/
Health Officer
10 27/ 54
(Official Designation)
(Date of Issue of Permit) 1/1-11
(write the word)
10a If married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
William A Floyd
(Husband's name in full)
DISEASE OR CONDITION DIRECTLY LEADING
TO DEATH
(a) CEREBRAL EMBOLISM WITH
RIGHT HEMIPLEGIA
2 WKS.
ANTE
Due To
CEDENT (b) ARTERIOSCLEROTIC
CAUSES
HEART DISEASE
4 YRS.
Due To (c)
GENERALIZED
ARTERIOSCLEROSIS
4 YRS.
OTHER SIGNIFICANT CONDITIONS
GANGRENE OF LEFT LEG
IWK.
Major findings:
Of operations.
MYONE
Date of operation ..
Was autopsy performed? No
What test confirmed diagnosis?
CLINICAL + LABORATORY
5 Was disease or injury in any way related to occupation of deceased ?. M.O. If so, specify. M. Traunstein fr. M. D. M. D.
(Signe
(Address) 562 SHIRLEY St, WinTHRODate
Winthrop
6 Place of Burial or Cremation
DATE OF BURIAL
19
7 NAME OF
FUNERAL DIRECTOR
Xaward S Popolato
ADDRESS
Received and filed OCT 27 1954
19
OCT. 23, .19 $ 4. MOTHER (City) (State or country)
Winthrop.
(City or Town)
Oct. 27 54
100M-(D)-10-48-24658
UCTIONS FOR CERTIFICATE
giving OF DEATH t enter than one for each b) and (c)
does not mean f dying, such lure, asthenia .. ns the disease. ations which h.
d conditions. ng rise to the (a) staling lying cause
ions contrib- death but not he disease or ausing death.
I R-301A 1
(City or Town) Winthrop Community Hospital No.
Registered No.
(If nonresident, give city or town and State)
Length of stay: In place of death
years
/
months.
5
3 DATE OF
DEATH
OCTOBER
23
1954
(Year)
(Month)
(Day) ›
(Registrar)
58
4
·
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.
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