USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1954 > Part 77
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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 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.
228
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number) No . Winthrop Community Hospital
2 FULL NAME .. Charles Fredric Anderson (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)
NO.
(a) Residence. No. . 95 Court Road.
St (If nonresident, give city or town and State)
Length of stay: In place of death .. years. 1 months. 7 days. In place of residence .15 years. .months ... . . days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATHI
October
27
(Day)
1954
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
23 Sept
54
to
27 Oct
1954
I last saw h & M alive on 27.
Oct
1954 death is said to
have occurred on the date stated above, at
1:10 Am.
INTERVAL BE- TWEEN ONSET AND DEATH 5 WKs
11 IF STILLBORN, enter that fact here.
12
AGE
5.0 Years
8 Months 28 Days
If under 24 hours
Hours
.. Minutes
ANTE
Due To
Vascular Disease
years
13 Usual
Photo Lithographer
(Kind of work done during most of working life)
14 Industry
Com. Printing Est
15 Social Security No. .
012-03-5919
16 BIRTHPLACE (City) . ..
(State or country)
Mass.
17 NAME OF
FATHER
Edwin F. Anderson
18 BIRTHPLACE OF
FATHER (City)
South Boston
(State or country)
Mass
19 MAIDEN NAME
OF MOTHER
Rachel Marine
20 BIRTHPLACE OF
MOTHER (City)
South Boston
6
Winthrop Cemetery
Winthrop, .Mass (State or country) MA.sS.
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL. October 30 1954, 19 /
7 NAME OF
FUNERAL DIRECTOR.
Ulkedts. March
ADDRESS
174 Winthrop St Winthrop, Mass. Walter A. Baker
Received and filed. OCT x 1954
(Registrar)
8 SEX
9 COLOR OR RACE
10 SINGLE
(write the word)
male
white
MARRIED
WIDOWEDmarried
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of Catherine Bernadette Maynes.
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
"Cebraum
DIRECTLY LEADING
TO DEATH (a) Cerebral Hemorrhage
Hypertensive
CEDENT (b)
CAUSES
Due To (c)
OTHER Hemorrhage.from
SIGNIFICANT a cute ulcer of
CONDITIONS
stomach
12 hrs
Major findings:
Of operations.
none
Date of operation.
Was autopsy performed?
no
What test confirmed diagnosis ?.
Clinical
5 Was disease of injury in any way related to occupation of deceased? no specifi other 0 M. D. (Signed) Date 28 Oct 1954 (Address) Minthrow
PARENTS
21 Informant Mrs. Charles F. Anderson (Address) 95 Court Road Winthrop
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)
Createthe Officer 10/29/54
(Official Designation) (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, ications which th.
id conditions. ing rise to the se (a) staling rlying cause
itions contrib- e death but not the disease or causing death.
SOM (8)-1-51 903586
-
19
To be filed for burial permit with Board of Health or its Agent.
(Usual place of abode)
(Month)
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 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 inne- 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 pernuts, 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, sltall 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 thercafter 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).
OF
TOW. $1.1% 7
RULES OF PRACTICE
The fulfilment 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 deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have droff Withbuf rofent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiner 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 def disabled by recognized disease, and those of persons foUG leda D
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)
Maurit @
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD
CERTIFICATE OF DEATH
Registered No.
229
2 FULL NAME
Mary J. Murray (Cooper)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
104 Highland Ave Winthrop
St. (If nonresident, give city or town and State)
Length of stay: In place of death 4 years. months. days. In place of residence .years months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
female
white
9 COLOR OR RACE
10 SINGLE
MARRIED
(write the word)
WIDOWED
or DIVORCED Widowed
4 I HEREBY CERTIFY,
That I attended deceased from
JUNE 11, 1951
to.
OCT 30
1954
I last saw h.
EL alive on
OCT 30
19 ST, death is said to
have occurred on the date stated above, at.
8150
m.
INTERVAL BE- TWEEN ONSET AND DEATH 2HRS .
11 IF STILLBORN, enter that fact here.
12
AGE 78
Years
Months.
Days
If under 24 hours
Hours ... Minutes
13 Usual
Occupation :
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
At Home
15 Social Security No. .
none
16 BIRTHPLACE (City)
(State or country)
Ireland
17 NAME OF
FATHER
Gilbert Cooper
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Cannot be learned
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
21 Informant (Address)
Daniel P. Doherty friend
64 Temple Ave Winthrop
7 NAME OF
FUNERAL DIRECTOR
Richard .... C ....... Kirby.
ADDRESS
917 Bennington Street E. Boston
NOV 1 1954.
19
Received and filed.
(Registrar)
10 yes.
(c)
Due TO SENILE PSYCHOSIS
2YRS
OTHER
SIGNIFICANT
CONDITIONS
NONE
Major findings:
Of operations.
NONE
Date of operation
.. Was autopsy performed?
What test confirmed diagnosis ?.
NONE
5 Was disease or injury in any way related to occupation of deceased? No
If so, specify.
(Signed)
myron D. Kung
M. D.
(Address) 222 PLEASANT ST. MINTHA Date
10/31 1954
Winthrop
Winthrop
6
Place of Burial or Cremation
(City of Town)"
DATE OF BURIAL
Nov.2
19.5.4
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter . Habery
(Signature of Ageat of Board of Health of other)
Thealth Officer
11/1/54
(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.
d conditions. ng rise to the (a) stating lying cause
ions contrib- death but not he disease or using death.
Chapter 137. 954, requires s to print or ause or causes on death es.
50M-3-54-911667
IR-301A 1
No.
104 .Highland Avenue 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
(a) Residence. No. (Usual place of abode)
3 DATE OF
DEATH
OCT
(Month)
(Day)
30
1954
(Year)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
James J. Murray
(Husband's name in full)
ANTE
Due To
ARTERIO-SCLEROTIC HEART
DISEASE
CEDENT (b) CAUSES
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a) ACUTE CORONARY OCC.
35
To be filed for burial -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 cleceased. 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 scen 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, 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 :
!)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
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 injury, have died, without recent medical attendance or whose physician is absent such permits, or if there is no such board, from the clerk of the town where the from home when the certificate of death is needed. person 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. 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 Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death. 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 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. 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
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING. ORGANIZATION AND OUTFIT SERVICE NUMBER
V
Plymouth
Whitman, Mass.
(City or Town) Bedford Street No.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
Whitman, Mass.
(City or town making return)
Registered No.
230
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
41 Cultler
Winthropf Mas's WAR)
St
21
(If nonresident, give city or town and State)
Length of stay: In place of death ...... .. years. months. .days. In place of residence .years months .days.
MEDICAL CERTIFICATE OF DEATH
30 1954
(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 Practured iskuindretk. Abrasions of Both Legs
11a If marri
Florence Gladstone
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
12 IF STILLBORN, enter that fact here.
13
24
6
AGE
Years
.. Months.
.. Days
If under 24 hours
Hours
Minutes
Salesman
14 Usual
Occupation:
(Kind of work done during most of working life)
15 Industry
Wholesale Foods
or Business:
16 Social Security No .. Boston
17 BIRTHPLACE (City)
(State or country)
18 NAME OF
FATHER
Edward Wolfe
-
19 BIRTHPLACE OF London,
FATHER (City)
England
(State or country)
20 MAIDEN NAME
OF MOTHER
Ida White
-
21 BIRTHPLACE OF
MOTHER (City)
.....
Russia
(State or country)
Edward Wolfe
-
22
41 Cutler St. Winthrop, Mass.
(Address)
A TRUE
mildred ME Penna
ATTEST:
(Registrar of City or Town where death occurred) October 30,1954 19
DATE FILED
........
-
Accident
5 Accident, suicide, or honfit(sp8(y).2:30PM-54
Date and hour of injury
19
Did injury occur in or about home, on farm, in industrial place, or in public place?
No
While at work?
Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased?
(Signed)
"ockton
10/30/ M54.
Tiferoth Israel of Winthrop Everett
7 Place of Burial, or Crematotober 31, (City or Town) 54
DATE OF BURIAL.
Hyman J ..... Forf.
19.
8 NAME OR FUNERALL, EdTashington .... St .. Chelsea ADDRESS
Received and filed.
NOV 4 ,1955
54
19
(Registrar of City or Town where deceased resided)
PERSONAL AND STATISTICAL PARTICULARS
10 COLOR OR RACE
White
11 SINGLE
MARRIED MEFried
WIDOWED
or DIVORCED
2 FULL NAME
(a) Residence. No.
(Usual place of abode)
3 DATE OF
Oct.
DEATH
Where did
Whitman, Mass.
Manner of
Auto Actrefere of place)
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