Town of Winthrop : Record of Deaths 1955, Part 30

Author: Winthrop (Mass.)
Publication date: 1955
Publisher:
Number of Pages: 570


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 30


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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 bylrecognizable disease, or when any person is found dead. ... - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4. Acts of 1945.


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 onthe 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).


g


RULES OF PRACTICE


He'fulfillment of the purpose of these laws calls for the observance of the follow- ules f practice: Attending physicians will certify to such deaths only as those of persons Igi they have given bedside care during a last illness from disease unrelated to 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 APRhave died without recent medical attendance or whose physician is absent henne 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


M R-301A 1


PLACE OF DEATH


X Suffolk (Counts) Winthrop (City or Town)


4-795 Doston


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH


To ba filad for burial ·permit with Board of Health or its Agent.


85


mayflower nursing Home No.


J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)


alice b. Brengtson


(If deceased is a married widowed or divorced woman, give also maiden name.) 7 Central Square


St.


(If nonresident, give city or town and State)


I.D.days. In place of residence. .. years. .. months. .. days.


MEDICAL CERTIFICATE OF DEATH


PERSONAL AND STATISTICAL PARTICULARS


3 DATE OF


DEATH


APRIL


21


(Month)


(Day)


1955


(Year)


8 SEX


Female


9 COLOR OR RACE


Muito


10 SINGLE


MARRIED


WIDOWER2


(write the word)


4 I HEREBY CERTIFY.


That I attended deceased from


April T.


19:55


to


April 21.


I last saw


h .... ...... alive on ...


ff.pl ......... ...... , 19 .. death is said to


10a If married, widowed, or divorced


HUSBAND of


Chivina


(Give maiden name of wife in full)


Bengtson


Husband's name ip full)


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Cancer of


2


12


39


Months


Days


If under 24 hours


Hours.


Minutes


ANTE


Due To


Cancer of


CEDENT (b)


CAUSES


Bowels


Due To (c)


OTHER


SIGNIFICANT


CONDITIONS


Malnutrition.


2 week


- 17 NAME OF FATHER Olaf mathisen


18 BIRTHPLACE OF FATHER (City) (State or country)


norway


19 MAIDEN NAME


OF MOTHER


ER Mary Scanlan


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


mass


Chring Benatone


21 Informant. (Address) 2 Jantarde E. Bolx


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:


natien G. Beaker


(Signature of Afewof Board of Health or other)


Ho


.


*/ ** /55


(Official Designation)


(Date of Issue of Permit)


X


50M-5-52-907046


7 NAME OF


FUNERAL DIRECTO Frederick magrath


ADDRESS.


Each Boston


Received and filed. APR 22 1955 19


(Registrar)


same


Occupation:


General Work


(Kind of work done during most of working life)


14 Industry


or Business


Malden Steam Laundry


15 Social Security No.


learnat de Learned


East Boston


16 BIRTHPLACE (City).


(State or country)


maas


Major findings:


Of operations


Cancer of Uterus + bowels.


Date of operatio


March


.Was autopsy performed? No.


What test confirmed diagnosis ?....... 1955 Physical finding .


5 Was disease or injury in any way related to occupation of deceased? NO


If so, specify.


(Signed)


(Address) 27 Princes Sf Date 20122-10


M. D.


6 ... nubilaum Place of Burial or Cremation


Salem (City or Town)


DATE OF BURIAL april 25


PARENTS


INTERVAL BE- TWEEN ONSET AND DEATH


11 IF STILLBORN, enter that fact here.


Uterus


19.5.5.


have occurred on the date stated above, at.


8.20P.


m.


(or) WIFE of


PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran,


{ if so specify WAR)


1


none


(a) Residence. No. (Usual place of abode)


Length of stay: In place of death. ........... years months.


2 FULL NAME


STRUCTIONS FOR AL CERTIFICATE


n giving E OF DEATH not enter re than one se for each , (b) and (c)


is does not mean le of dying, such failure, asthenia. means the disease. plications which leath.


rbid conditions, giving rise to the use (a) stating derlying cause


ditions contrib- the death but not o the disease or n causing death.


Cambridge


13 Usual


month


· AGE


.Years


Registered No.


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 violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.


No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, froin the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.


Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:


(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.


(2) Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have 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, desiguate the occupation by the appropriate terms, as housekeeper-private family cook- hotel, etc. For a person who had no occupation whatever write hon


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


APR22


11.12


NIW


OF TOWN


RECEIVED


PM


17


ORGANIZATION AND OUTFIT


SERVICE NUMBER ..


DATE OF DISCHARGE


RANK, RATING


PLACE OF DEATH


Suffolk (County)


The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS


STANDARD CERTIFICATE OF DEATH Que


Registered No. 86


J(If death occurred in a hospital or institution, :. St. \ give its NAME instead of street and number) Burton PHYSICIAN - IMPORTANT


(Was deceased a


U. S. War Veteran.


if so specify WAR)


(a) Residence. No. (Usual place of abode)


Length of stay: In place of death 5 years. months. days. In place of residence.


5


... years


.months


.days.


MEDICAL CERTIFICATE OF DEATH


3 DATE OF


DEATH


april


21


1955


(Year)


(Month)


(Day)


4 I HEREBY CERTIFY .


That I attended deceased from


19


to


19


I last saw h.


alive on


19 ........ death is said to


have occurred on the date stated above, at


11:15 A.m.


INTERVAL BE- TWEEN ONSET AND DEATH


DISEASE OR CONDITION


DIRECTLY LEADING


TO DEATH (a)


Natural Causes


ANTE


Due To Presumably Coronary


CEDENT (b)


CAUSES


Occlusion


Du (c)


· Generalized Arterio- Sclerosis


OTHER SIGNIFICANT CONDITIONS


Major findings:


Of operations.


Date of operation


Was autopsy performed? 10


What test confirmed diagnosis ?.


5 Was disease or injury in any way related tooccupation of deceased? no If s arthur C. Murray


M. D.


6 Winthrop Place of Burial or Cremation


(City or Town)


DATE OF BURIAL


april 23


1955


Howards. alehold


ADDRESS


Received and filed APR 22 1955 19


(Registrar)


PERSONAL AND STATISTICAL PARTICULARS


8 SEX


Female


9 COLOR OR RACE


White


10 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


widowed


10a If married, widowed, or divorced HUSBAND of (Give maiden name of wife in full). Thomas Burton (or) WIFE of (Husband's name in full)


11 IF STILLBORN, enter that fact here.


12


AG


91


Years


1


Months 27


Days


If under 24 hours


Hours ....


. Minutes


13 Usual


Occupation :


write


(Kind of work done during most of working life)


14 Industry


or Business:


at home


15 Social Security No .... nove 16 BIRTHPLACE (City) Feelers Graut (State or country) nova serca


17 NAME OF FATHER William Grant


18 BIRTHPLACE OF FATHER (City) (State of country) nova vertex


19 MAIDEN NAME OF MOTHER Unable to obtain


20 BIRTHPLACE OF


MOTHER (City)


(State or country)


novasertia


Unable to attain


Charlotte B. Hall


21 Informant. (Address) 112 Jarrace Que


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: W.W. G. Kaker


(Signature of Ager) of Board of Health or other)


H.0


4/22/55


(Official Designation)


(Date of Issue of Permit)


X


M R-301A 1


RUCTIONS FOR L CERTIFICATE


giving OF DEATH not enter than one for each (b) and (c)


does not mean of dying, such ilure, asthenia. - ans the disease, ications which ath.


id conditions. ving rise to the se (a) stating rlying cause


itions contrib- e death but not the disease or causing death.


:- Chapter 137. 1954, requires ans to print or cause or causes th on death ates.


SOM-3-34-911667


No.


(City or Town) 112


nettie(Graut)


(If deceased is a married, widowed or divorced woman, give also maiden name.)


112 Terrace


(If nonresident, give city or town and State)


To be filed for burial ·permit with Board of Health or its Agent.


PARENTS


Fishers Drauf


(Signed)


dre Winthrop Board of Health


Date 2 2 Abril 19:55


7 NAME OF


FUNERAL DIRECTOR


180 Winthrop 25+


2 FULL NAME


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 he 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- een, shall. if the deceased, to the best of his knowledge and belief, served in the rmy, 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 hall also certify in such certificate both the primary and the secondary or imme- liate 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 elief expedition and the Philippine insurrection, which shall, for said purposes, be leemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border ervice of nineteen hundred and sixteen and nineteen hundred and seventeen. J. L. Chap. 46, Sec. 10.


No undertaker or other person shall bury or otherwise dispose of a human body n a town, or remove therefrom a human body which has not been buried, until he tas received a permit from the board of health, or its agent appointed to issue uch permits, or if there is no such board, from the clerk of the town where the erson died; and no undertaker or other person shall exhume a human body and emove it from a town, from one cemetery to another, or from one grave or tomb ther than the receiving tomb to another in the same cemetery. until he has eceived a permit from the board of health or its agent aforesaid or from the clerk f the town where the body is buried. No such permit shall be issued until there hall have been delivered to such board, agent or clerk, as the case may be. satisfactory written statement containing the facts required by law to be eturned and recorded, which shall be accompanied, in case of an original inter- nent, by a satisfactory certificate of the attending physician, if any, as required by aw, 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 nough 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 aused by violence, the medical examiner shall make such certificate. If such a ermit for the removal of a human body, not previously interred, from one town o 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 he undertaker desiring to make such removal shall constitute a permit for such emoval; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the


SPACE FOR ADDITIONAL INFORMATION


DATE OF ENTERING MILITARY SERVICE


DATE OF DISCHARGE


RANK, RATING


ORGANIZATION AND OUTFIT.


SERVICE NUMBER


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., (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 oceupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.


No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.


Chap. 114, Sec. 46, G. L., (Tercentenary Edition).


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:


(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, ftc) For a person who had no occupation whatever ,write.none.




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