USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 12
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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
A R-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No. 24 Perkins Street
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.
32
Registered No.
J(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
2 FULL NAME .. Gladys Elizabeth Tuckerman
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. (Usual place of abode
24 Perkins Street
St.
(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
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
female white
9 COLOR OR RACE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
single
10a If married, widowed, or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
b7Years
5
.Months
25Days
If under 24 hours
Hours ... ... Minutes
13 Usual
Occupation :.
none- crippled since her
(Kind of work done during most of working life)
14 Industry
or Business :.
filh birthday by fall.
15 Social Security No ...
none
16 BIRTHPLACE (City) (State or country) Mass
17 NAME OF FATHER Albert Williams Tuckerman
18 BIRTHPLACE OF
FATHER (City)
Boston
(State or country)
Mass.
19 MAIDEN NAME
OF MOTHER
Rebecca Josephine DEN
20 BIRTHPLACE OF
MOTHER (City)
Brooklyn
(State or country)
New York
21 Charles D. Tuckerman
Informant (Address) 24 Perkins 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 G. Baker
(Signature of Adeal of Board of Health or other) HC.
2/14/95
(Official Designation)
(Date of Issue of Permit)
X
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.
OTHEROLD SPINE INJURY WITH PARALYSIS SIGNIFICANTAAMS-LEGS- MECK- CONDITIONS PARA PLEGIE SINCE AGE 8
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 ?. NO
If so, specify ....
a.n. caplan
M. D.
(Signed),
(Address) 19 MERMAID AVE WINTHROP
2-131965
Everett . Mass.
6 Woodlawn Creamatory .......
Place of Burial or Cremation
(City of Town)
DATE OF Ereemation February, 14 1955
7 NAME OF
FUNERAL DIRECTOR
Alfred Bb. March
ADDRESS 774 Winthrop St. Winthrop, Mass.
Received and filed FEB 14 1955 19
(Registrar)
5 days
BUTTOX
smo
ANTE
Due To
SMU
CEDENT (b)
CAUSES
Due TO DECUBITUS LEFT (c)
Stoneham
PARENTS
SOM (B)-1-51 903586
3 DATE OF
DEATH
February 13,1955
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
JUNE 8, 1953.
to.
FEB
121
19.5.3.1
I last saw hEl alive on.
FEB.12
195.S., death is said to
have occurred on the date stated above, at
10.45 A.m.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) CARDIAC DECOMPENSATION
CHRONIC MYOCARDITIS
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR) NO.
Dennis on
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 way. contracted. the duration of his last illness, when last secn 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. sha". 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 beety 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 andh 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 eannot 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. shal 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 E Ossblev le 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.
Transfertaker 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 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 funeralis 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
Thevatfilment of the purpose of these laws calls for the observance of the follow- Ing rGles et 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 njery, have died without recent medical attendance or whose physician is absent Ebon 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 oceupation 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 Bunty)
Winthrop (City or Town)
No. 73 Chester Avenue
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.
33
2 FULL NAME ..
John Maw Jr. (If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, NO.
if so specify WAR)
(a) Residence. No.
(Usual place of abode)
73 Chester Avenue
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.4.7. years ..
.months. days. In place of residence 47 years months .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
February 15,1955
(Year)
(Month)
4 I HEREBY CERTIFY,
That I attended deceased from
JAN. 29
19
55
to ..
FEB. 15
1955.
I last saw h. I.M .alive on.
FEB. 14
195S, death is said to
have occurred on the date stated above, at
:4:45 Am.
INTERVAL BE-
TWEEN ONSET
AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING/
TO DEATH (a)
LOBAR PNEUMONIA
RIGHT
ANTE
Due
CEREBRAL HEMORRHAGE
CEDENT (b)
CAUSES
with Rt. HEMIPARESIS
Due To (c)
OTHER SIGNIFICANT CONDITIONS
HYPERTENSIVE + ANTERIO. SCLEROTIC HEART DISEASE
5YRS.
Major findings:
Of operations.
NONE
Date of operation
NONE
..... Was autopsy performed?
No.
What test confirmed diagnos
CLINICAL + LABORATORY.
5 Was disease or injury in any way related to occupation of deceased? NO. If so, specify. (Signed) Maurice Traunstein, M. D. (Address) 162 SHIRLEY ST. WINTHROde FEB. 15, 1955.
6 Winthrop Cemetery Winthrop , Mass Place of Burial or Cremation "(City or Town)
DATE OF BURIAL February 17 1955
7 NAME OF
FUNERAL DIRECTOR
Ufuel 12 March
ADDRESS 174 Winthrop St. Winthrop,
Received and filed VEB 16 1955 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR OR RACE
10 SINGLE (write the word) MARRIED married WIDOWED or DIVORCED
male white
10a If married, widowed, or divorced
HUSBAND of . Anna Davies Hutchinson
(Give maiden name of wife in full)
(or) WIFE of ..
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
12
AGE74 Years
3 Months .. ... Days
If under 24 hours
Hours .
Minutes
13 Usual
Occupation:
Retired Datant maker
(Kind of work done during most of working life)
14 Industry
Shipbuilding Co.
15 Social Security No.023-12-0767-4.
16 BIRTHPLACE (City)
Montreal
(State or country) Canada
17 NAME OF FATHER John Maw
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
19 MAIDEN NAME
OF MOTHER
Elizabeth Nourse
20 BIRTHPLACE OF MOTHER (City) (State or country) Canada
21 Informant Mrs ....... John .... Maw.
(Address) 73 Chester Ave. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Mass.
Watter &Shakes
(Signature of Agent of Board of Health(or other)
Health Offeeer 7/26/35
(Official Designation ) (Date of Issue of Dermit)
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 ath.
id conditions. ing rise to the se (a) stating rlying cause
itions contrib- e death but not the disease or causing death.
5.
SOM (B)-1-51 903586
M R-301A 1
Registered No.
J(If death occurred in a hospital or institution, St. \ give its NAME instead of street and number)
4 DAYS
18 DAYS
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.
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 REfeitatinh 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).
TOW.
Medtralexaminers shall make examination upon the view of the dead bodies of persons gas are supposed to have died by violence, or by the action of chumnicaky, thermar or electrical agents or following abortion, or from diseases trestilting 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 ør other persons shall bury a human body or the ashes thereof ,which have been brought into the commonwealth until he has received a permit sg'tu;de.from the board of health or its agent appointed to issue such permits, or there is no such board, from the clerk of the town where the body is to be buried on 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
FEB17 PAM
he 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)
R-301A 1 Winthrop (City or Town)
No.
Winthrop Community Hospital
J(If death occurred in a hospital or institution.
St. [ give its NAME instead of street and number)
2 FULL NAME Catherine S. Collins (McCarthy)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
4 Johnson Ave .. Winthrop St.
(a) Residence. No.
(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 6 .years. .. months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
· (write the word)
MARRIED
WIDOWED
or DIVORCEDWidowed
4 I HEREBY CERTIFY,
That I
attended deceased from
19
JAN
24, 1955
to.
2/17
55
I last saw her alive on
2/16
19.55, death is said to
have occurred on the date stated above, at 1: 23 H m.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING A Coronary
TO DEATH (a)
Thrombosis
Sudden ShrS.
3 yrs.
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Chrome BronchiEstasis
2yrs.
Major findings:
Of operations.
0
Date of operation
0
Was autopsy performed?
What test confirmed diagnosis?
0
5 Was disease or injury in any way related to occupation of deceased ?. 120
If so, specify D Patti
(Signed)
(Address) ()a Bennington STEB Date 2/17
1955
M. D.
6 Holy Cross Cemetery, Malden Place of Burial or Cremation (City or Town)
DATE OF BURIAL
February19th
19.5.5
7 NAME OF
FUNERAL DIRECTOR
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