USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 27
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Was autopsy performed? .
What test confirmed diagnosis? CLINICAL.
5 Was disease or injury in any way related to occupation, of deceased? No .
If so, specify
(Signed)
myron b. King
M. D.
(Address) 222 PLEASANT. ST. WINTHROP 4/8
19.53-
6 ..
Holy Cross
Place of Burial or Cremation
maldin ity or Town)
DATE OF BURIAL
april 6
1955
7 NAME OF FUNERAL DIRECTOR Charles H. Treanor
ADDRESS East Boston
Received and filed. APR 4. 19
(Registrar)
PARENTS
18 BIRTHPLACE OF FATHER (City) (State or country)
Ireland
19 MAIDEN NAME OF MOTHER
Margarel malar
20 BIRTHPLACE OF MOTHER (City) (State or country)
anna,
Kelly
21 Informant 12 abbott Que Everett
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter of Hakes (Signature of Agent of Board of Health or other) Healtho Htwell 4/4/55
(Official Designation) V
(Date of Issue of Permit)
X
RM R-301A 1
STRUCTIONS FOR AL CERTIFICATE In giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean de of dying. such failure. asthenia, means the disease. plications which death.
orbid conditions, giving rise to the ause (a) stating derlying cause
nditions contrib- the death but not to the disease or n causing death.
50m-(b)-11-49-900,560
PLACE OF DEATH
(City or Town) /Mouguts Come/ CERTIFICATE OF DEATH 104 Highland Que No. .
Registered No.
(If deceased is a married, widowed or divorced woman, give also maiden name.) 81 Elm It
(a) Residence. No. (Usual place of abode)
Length of stay: In place of death 3 years 8 months. 6 days. In place of residence .years
St.
have occurred on the date stated above, at 6 17 .. m. INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
ACUTE CORONARY
OCCLUSION
6 days
ANTE CEDENT (b) CAUSES
Due To
GENERAL ARTERIO-
SCLEROSIS AND
Due To
ARTERIO - SCLEROTIC
(c)
HEART DISEASE
5 YRS.
OTHER SIGNIFICANT CONDITIONS
PARKINSONIAN DISEASE
5 YRS
home
Ireland
(write the word)
(Day)
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 are supposed to have died by violenec, 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 diseases 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 of the ashes thereof which have been broughtinto the commonwealth until he has received a permit so to do from the boardof health or its agent appointed to issue such permits, or if there is no sucb fr frd] [fout the clerk of the town where the body is to be buried or the funeral is to Be hoff,or from a person appointed to have the care of the cemetery, or burial ground for which the interment is made.
Chap, 11; Sec. 46. G. I. (Tercentenary Edition).
. .
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice: 5
(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 willinvestigate 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
Winthrop (County)
RM R-301 - Suffolk (City or Town)
No.
Winthrop Community Hospital
[(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME. Nellie Mary Jenner
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 35 Shirley Street (Usual place of abode)
........
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ...... .years. months .... 6 ..... days. In place of residence .years. months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
April
8
1.9.5.5
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
April 1, 1955
to ..
April 8, 1955 19.
er
April 8,
55
19.
death is said to
have occurred on the date stated above, at. m.
INTERVAL BE- TWEEN ONSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Heart Disease
Arteriosclerotic
2 Yrs
12
AGE 76 Years
3 ... Months.
Days
If under 24 hours
Hours ...
.. Minutes
ANTE
CEDENT (b)
CAUSES
Due To
Arteriosclerosis
5 Yrs.
13 Usual
Occupation:
housework
(Kind of work done during most of working life)
14 Industry
or Business:
own .... home
15 Social Security No.
none
16 BIRTHPLACE (City).
(State or country)
Ireland
OTHER
SIGNIFICANT
Arteriosclerotic. CONDITIONS Gangrene Right Foot
4 days
Major findings:
Of operations.
None
Date of operation.
--
Was autopsy performed ?.
no
What test confirmed diagnosis ?.
Electrocardiogram
5 Was disease or injury in any way falated to occupation pieces
If so, specify ..... ]
(Signed)/
Revere Mass,
leceased+ ... no
April 8. M55P.
(Address)
Date
6
Winthrop Cemetery
Winthrop, Mass.
Place of Burial or Cremation (City or Town)
DATE OF BURIAL April 11 11955 19
7 NAME OF
FUNERAL DIRECTOR
alfred to March
ADDRESS.
774 Winthrop St. Winthrop,
Received and filed
APR 11 1955
19
(Registrar)
PARENTS
19 MAIDEN NAME
OF MOTHER
Ellen Burke
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21 Informant Miss Catherine Jenner (Address) 35 Shirley St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Ma.s.s ...
(Signature of Agent of Board of Health or other)
(Official Designation)
(Date of Issue of /Permit)
-
V.B. V
TRUCTIONS FOR . CERTIFICATE giving OF DEATH
not enter than one e for each (b) and (c)
does not mean of dying, such ilure, asthenia, ans the disease, ications which ath.
rbid conditions, ving rise to the se (a) stating erlying cause
ditions contrib- e death but not the disease or causing death.
50M-(A)-11-51-905807
1
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Winthrop
(City or town making return)
78
Registered No.
(Was deceased a
U. S. War Veteran,
if so specify WAR)
55
9 COLOR OR RACE
8 SEX
female white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
1
(write the word)
widowed
I last saw 1
alive on
4.20 P.M
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
John .... Joseph Jenner.
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
Due To (c)
17 NAME OF
FATHER
Patrick Shea
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Treland
4/16/56
A TRUE COPY ATTEST:
That I attended deceased from
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered bospital medical officer shall fortbwitb, after the deatb 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, tbe 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 Cbina relief expedition and the Philippine insurrection, which shall, for said purposes, he 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 seven- teen. 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 be has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such hoard, 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 bas 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 tbere 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 hy 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 hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a human hody, 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 registration. 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 .- Cbap. 114, Sec. 45, G. L., (Tercentenary Edition). .
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go. to the place where the body lies and take charge of the same; R CEEal Vaws, Chap. 38, Sec. 6.
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 for 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_ 11+/Sec 46, G. L., (Tercentenary Edition).
C.P .:
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the following rules of practice :
(1)Anending 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 person's ' 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 tie 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, hut also deaths from disease resulting from injury or infection related to occupa. tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa. tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE
RANK, RATING.
ORGANIZATION AND OUTFIT
SERVICE NUMBER
X PLACE OF DEATH
Suffolk (County)
Winthrop (City of Town)
No. Mount's Regt Home
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.
Margaret Teresa Doherty 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
41 Bates Ave
St.
(If nonresident, give city or town and State)
Length of stay: In place of death years
months. 2,0 days. In place of residence .years months . . days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDidowed
4 LHEREBY CERTIFY,
That
I
attended deceased from
1955
Cemil /
1955
to
I last saw her alive on
10 : 195 ), death is said to
have occurred on the date stated above, at
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a)
0
TWEEN ONSET AND DEATH 4 days
1.
ANTE
Due To
CEDENT (b) .
CAUSES
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Major findings:
Of operations
2.2824
Date of operation.
Zien21 Was autopsy performed? 220
What test confirmed diagnosis? .
Cline al Signs
5 Was disease or injury in any way related to occupation of deceased?
If so, specify.
(Signed)
(Address) Winthrop News Date Cruel 12/2055
M. D.
Holy Cross
Malden Mass
(City of Town)
DATE OF BURIAL
April 13
155
7 NAME OF
FUNERAL DIRECTOR.
ADDRESS
Winthrop,
APR 13'19539 8
Received and filed 19
(Registrar)
.74
+ 12
AGE
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:
Own Home
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Ireland
17 NAME OF
FATHER
Michael
Flynn
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Catherine Leahy
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Treland
Mae Marsh
21 Informant (Address) 41 Bates Ave., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with næ BEFORE the burial of transit permit was issued:
Wolter & Bakery
(Signature of Agent of Board of Health or other)
I Leatthe Shell 4/12/55 X
(Official Designation) (Date of Issue of Permit)
J
RM R-301A 1
STRUCTIONS FOR AL CERTIFICATE In giving E OF DEATH not enter re than one se for each ), (b) and (c)
is does not mean de of dying, such failure, asthenia, means the disease, plications which death.
orbid conditions, giving rise to the ause (a) stating derlying cause
nditions contrib- the death but not to the disease or n causing death.
50m-(b)-11-49-900,560
Registered No. ..
104 Highland Ave!(If death occurred in a hospital or institution, ( give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. (Usual place of abode)
8
9 COLOR OR RACE
(write the word)
3 DATE OF
DEATH
April 10, 1955
(Month)
(Day)
(Year)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Edward Doherty
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
PARENTS
6
Place of Burial or Cremation
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.
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