USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 15
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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. Sep. 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 dø from the board of health or its agent appointed to issue such permits, or if there istno 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 on burial ground in which the interment is made.
ham. 114; Sec. o.G. L., (Tercentenary Edition).
9 3 RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules Ofpractices 3 Thy physicians will certify to such deaths only as those of persons to whom they have won bedside care during a last illness from disease unrelated to ans/tør ofund
(2) BoatDof 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.
MARdichExaminergwill investigate and certify to all deaths supposably ry. roThese indide 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
M R-301A 1
PLACE OF DEATH
Suffalle (County)
Winthrop (Giyy or Towy
The Commonwealth of Massachusetts EDWARD J. CRONIN, SECRETARY DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
39
Nunctrop Gom Wask. No!
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Henry . Haselton
(If deceased is a married, widowed or divorced woman, give also maiden name.)
54 6 Akuson ane. St.
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death years .. 2 .. months .. days. In place of residence
12 years
months days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF DEATH
February (Month)
(Day)
25 1955 (Year)
8 SEX
Male
9 COLOR OR RACE
1 hete
10 SINGLE MARRIED WIDOWED or DIVORCED
(write the word)
Married
4 J HEREBY CERTIFY,
July 3 1954
to
unalive on. February 1, 25
, Death is said to
have occurred on the date stated above, at 1:30pm
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12 AGE 6Years
Months Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Jecarter
(Kind of work done during most of working life)
14 Industry or Business :.... Juvely
15 Social Security No.
16 BIRTHPLACE (City) .. (State or country)
17 NAME OF FATHER
John Y Naselton
18 BIRTHPLACE OF FATHER (City) (State or country)
England
19 MAIDEN NAME OF MOTHER
Pose Sofriam
maryland
1
50M-2-19.25666
7 NAME OF FUNERAL DIRECTOR ADDRESS 210 Hauehaubist duchat
Received and filed FEB 2.8 .1955 .19
(Registrar)
40a
HUSBAND of . Corina on numara
(or) WIFE of
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LESDIYE
adeno CARCINOMA
TO DEATH
OF descENDING colon
ANTE CEDENT (b) . GENERAL
CAUSE ARCINOMATOSIS
Due To (c)
OTHER SIGNIFICANT CONDITIONS
UREMIA
24 hrs.
Major fi Of opera ADENOCARCINOMA of colon Date of opera July 3 w/ autopsy performed; no What test confirmed diagnosis CLINICAL & path.
5 Was disease or injury in any way related to occupation of deceased? 0 . If so, specify. educob J. abrams Zund M. (Add ) 542 SHIRLEY ST Date 2/27/515
D.
WINTHROPHASS (City or Town)
6 Place of Burial of Cremation
DATE OF BURIAL Fuel 22 1852
21 Informant (Address)
annas Resetten 54 Jamon Que Nucleus
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Walter &. Kaker (Signature of Agent of Board of Health of other) Healthe office
2/28/50
(Official Designation)
(Date of Issue of Permit)
TRUCTIONS FOR L CERTIFICATE
giving OF DEATH not enter than one e for each (b) and (c)
does not mean of dying, such ilure, asthenia. cans the disease, lications which ath.
bid conditions. ving rise to the se (a) stating erlying cause
itions contrib- he death but not the disease or causing death.
PARENTS
20 BIRTHPLACE OF MOTHER (City) (State or country)
Registered No.
2 FULL NAME.
PHYSICIAN - IMPORTANT (Was deceased a
U. S. War Veteran, if so specify WAR)
attended deceased from
February 25/50
(Give maiden name of wife in full)
6 mus
3 mars
@ Boston Mas
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 arrny, 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 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 suchi 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 mace 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 inake 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 discasc, 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 IT, Sec.46. G. L., (Tercentenary Edition).
OF
TOW; 12 1
11
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- g Putes of prartic Att hung yNolans will certify to such deaths only as those of persons bedside care during a last illness from disease unrelated
and fordi injue
20 Board of Alth physicians will certify to such deaths only as those of Magh disabled by recognized disease unrelated to any form of Gt recent medical attendance or whose physician is absent entificate of death is needed.
ענחו
diners will investigate and certify to all deaths supposably due these include not only deaths caused directly or indirectly by traumatis (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, FEB28 Ths of periths not disabled by recognized disease, and those of
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 occup :- 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
.
1 R-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
15 Johnson Ave. No.
f(If death occurred in a hospital or institution. St. \ give its NAME instead of street and number)
Lily (Smart ) Hancock 2 FULL NAME ..
(If deceased is a married, widowed or divorced woman, give also maiden name.)
15 Johnson Ave .
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
3 DATE OF
DEATH
Feb
(Month)
26
1955
8 SEX Female
9 COLOR OR RACE White
10 SINGLE
(write the word)
MARRIEDWidowed
WIDOWED
or DIVORCED
4 I HEREBY CERTIFY,
That I attended deceased from
Sejat.
19
45
to ..
Feb. 26
1955
I last saw her .C .alive on Feb. 26 1922, death is said to
have occurred on the date stated above, at.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
81
12
AGE
Years'
10
19
Days
If under 24 hours
Hours ... ... Minutes
13 Usual
Occupation:
Home Maker
(Kind of work done during most of working life)
14 Industry
or Business:
At Home
15 Social Security No.
None
Scotsburn
16 BIRTHPLACE (City).
(State or country)
Nova Scotia
17 NAME OF FATHER William Smart
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Aberdine
(State or country) Scotland
19 MAIDEN NAME OF MOTHER Catherine Mackay
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Earltown
Nova Scotia
21 Informant. Frances Key
(Address)
15 Johnson Ave, Winthrop,
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)
HO
2/28/55
(Official Designation)
(Date of Issue of Pepmit)
V.B. V
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure, asthenia, ins the disease, cations which th.
d conditions. ing rise to the e (a) stating lying cause
tions contrib- death but not he disease or ausing death.
- Chapter 137. 1954, requires ns to print or cause or causes th on death tes.
50M-3-54-911887
X
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
40
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. (Usual place of abode)
30
30
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Thomas G. Hancock
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
CORONARY THROMBOA
1 day
ANTE
Due To
HYPERTENSION
CEDENT (b)
CAUSES
10 yrs
Due To (c)
OTHER SIGNIFICANT CONDITIONS
DIABETES
5 yrs
Major findings:
Of operations.
-
Date of operation
Was autopsy performed? 20
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, spe
Laws 7 Salerno
(Signed). .
(Address) 175 Placesand ST
...
M. D.
Date Feb-26 1955
Winthrop Cemetery
Winthrop
6 Place of Burial or Cremation DATE OF BURIALMarch 1
(City or Town)
55
19
7 NAME OF
FUNERAL DIRECTOR.
ADDRESS
180 Winthrop St .Winthrop
FEB 28 1955
Received and filed 19
(Registrar)
Victoria Q. Kumolde
(Day)
(Year)
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 deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased. his supposed age, the disease of which he died. defined as required by section one. where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the › preceding section or by section forty-five of chapter one hundred and four- teen, shall. if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been ( engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five. forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician. if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if. for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose. the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as fare 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. 138. Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
o .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 derk 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).
6 RULES OF PRACTICE
/ /THe tufflbment 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
FEB.angform 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 in jury, 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
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