USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 18
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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 Kresulting 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.
TOW undertaker or other persons shall bury a human body or the ashes thereof which Race been brought into the commonwealth until he has received a permit so th'da for the board of health or its agent appointed to issue such permits, or if there is no such toand from the clerk of the town where the body is to be buried ot the funeral & to be held, or from a person appointed to have the care of the cemetery or buffalutound in which the interment is made.
9 & Chạp: 111, 8ec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
C, of the purpose of these laws calls for the observance of the follow-
mattite. UST 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 MAR who. though Idisabled by recognized disease unrelated to any form of HA 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
× PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
51
Registered No.
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number) No.
2 FULL NAME Angus. Relman Lohnes. (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)
15 Crystal cove Ave.
St
(If nonresident, give city or town and State)
Length of stay: In place of death years .months. : days. In place of residence 14
.years
... months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
March.9
(Month)
(Day)
1955
(Year)
4 I HEREBY CERTIFY.
That I attended deceased from
march 2, 19 J'5
to ..
march 9,
19.05
I last saw him alive on march 9, 1955, death is said to
have occurred on the date stated above, at . m.
INTERVAL BE-
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
70 Years
6
Months
28 Days
If under 24 hours
Hours
.Minutes
13 Usual
Occupation :
Retired Yacht captain
(Kind of work done during most of working life)
14 Industry
or Business:
Private Yacht.
15 Social Security No.
023-12-7488
16 BIRTHPLACE (City)
(State or country)
Nova scotia
17 NAME OF FATHER Israel Lohnes
18 BIRTHPLACE OF
FATHER (City)
Port Medway
(State or country)
Nova Scotia
19 MAIDEN NAME
OF MOTHER
Elizabeth Ann Gaskill
20 BIRTHPLACE OF
(Address)
794 W alcune ask Date 3-11
1900
MOTHER (City)
Port Medway
Place of Burial or Cremation
DATE OF BURIAL
March 22,
1955
7 NAME OF
FUNERAL DIRECTOR
Alfred 3. March
ADDRESS
174 inthison st.
winthrop
Received and filed. march 14 1
(Registrar)
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Marned
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Coronary
Occlusion
TWEEN ONSET AND DEATH 2hrs
ANTE
Due To
arterioscrematie
CEDENT (b) CAUSES heart disease
Due To (c) Hypertension essential
OTHER SIGNIFICANT CONDITIONS
Penetrating duodenal
weer
1 Lakele
Major findings:
Of operations
Date of operation
Was autopsy performed? 200
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify.
egone
M. D.
Winthrop Cemetery 6
inthrop (City or Town)
(State or country)
Nova Scotia
21 Informant Floyd Travis Iohnes (Address) 15 Crystal Cove Ave.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter A. Lakers (Signafure of Agent of Board of Health or other)
3/12/55
(Official Designation) (Date of Issue of Permit) X
SOM (B)-1-51 903586
R-301A 1
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.
l conditions. ng rise to the : (a) staling lying cause
ions contrib- death but not he disease or using death.
gp
Port Medway
PARENTS
10a If married, widowed, or divorced
HUSBAND of.
Josephine Norton
(Give maiden name of wife in full)
(or) WIFE of
(a) Residence. No. (Usual place of abode)
Winthrop Community Hospital
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 rehef 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 ninctcen 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 chemionly thefraklofelectrical 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.
uhertaker 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 sò. todo from the board of health or its agent appointed to issue such permits, or if there'is no such beard, from the clerk of the town where the body is to be buried of the funeralas to be held, or from a person appointed to have the care of the cemetery of burial ground in which the interment is made.
Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
6 RULES OF PRACTICE
The thiiment 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.
JAPfand of Health physicians will certify to such deaths only as those of an wed 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
Every item of
N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD.
50M-10-53-910621
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect. of Death. See reverse side for extracts from the lews relative to the return of certificetes of death. DEATH in plain terms, so that it mey be properly clessified under the Internetionel Classification of Causes informetion should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
PLACE OF DEATH
(County) Wurth 20 (City or TownY 42 Jain St.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No. ....
52
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
No. Daniel Mac. Lean 2 FULL NAME
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 42 Main St. Winthrop
(a) Residence. No. (Usual place of abode)
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
march 11-1955
DEATH
(Month) (Day)
(Year)
9 SEX
Male
10 COLOR OR RACE
White
11 SINGLE
MARRIED
WIDOWED
or DIVORCED Single
4 I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) ar terio 5 clerotic Heartsease:
11a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
General arterio Sclerosis
Seuilite
5 Accident, suicide, or homicide (specify)
Date and hour of injury
19
Where did
Injury occur?
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in public place?
Manne
Injury
(Specify type of place)
Nature of
(How did injury occur?)
Injury
mar -11-1955
While at work?
Was autopsy performed?
6 Was disease or injury in any way related to occupation of deceased?
If so, specify
(Signed)
M. D.
(Address)
Holy Cross
Malden Mags
-
DATE OF BURIAL.
March 140
19 .. 55
8 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop Mass
Received and filed 19:
(Registrar)
PARENTS
19 BIRTHPLACE OF
FATHER (City).
(State or country)
Nova Scotia
20 MAIDEN NAME
OF MOTHER
Catherine MacDonald
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Nova Scotia
22
Informant
(Address)
42 Main 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 A takes
(Signature of Agent of Board of Health or other)
Thealik officee
3/11/55
(Date of Issue of Permit)
(Official Designation)
Agnes MacLean
7 Place of Burial, or Cremation. (City or Town)
456-11-
1955
12 IF STILLBORN, enter that fact here.
70
13
AGE
Years
Months.
Days
If under 24 hours
Hours .....
.. Minutes
14 Usual
Occupation :.
Retired
(Kind of work done during most of working life)
15 Industry
or Business:
Carpenter
16 Social Security No ..
none
17 BIRTHPLACE (City)
(State or country)
Nova Scotia
18 NAME OF
FATHER
Hugh MacLean
.
111.5.
01
RM R-303 A 1
50
(write the word)
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, See. 45, G. L. as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.
No undertaker or other person 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., as amended.
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.
The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RECEIVE!
RULES OF PRACTICE
The 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 trauinatism. (including resulting septicemia), and by the action of chemical (drugs dhpoisons) 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.
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