USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 33
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8 SEX ale
9 COLOR OR RACE
wLito
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
10a If married, widowed, a divorced Mary kinnear HUSBAND of. (Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
ANTE
CEDENT
(b)
Due To
ypostatic
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
none
Date of operation
.Was autopsy performed ?.
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased? If so, specify .......................... Uns (Signed) 37 Saway., veroti.Apr. 2M53. .(Address):
6 Place of Burial or Cremation (City or Town) april 26, 55 19
DATE OF BURIAL
Alfred B. Harsh
7 NAME OF
FUNERAL DIRECTOR
Intirop ., Int Top
ADDRESS.
Received and filed.
MAY 16 1955 19
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time 25M (E)-6-50-902253 after the close of the month in which the death occurred. (See Chap. 46, Ser 12, G. L.) of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible CAUSES
PLACE OF DEATH
M R-302 1
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
PARENTS
76 1
retired attendance o fice
1week
PERSONAL AND STATISTICAL PARTICULARS
1955
St.
(Was deceased a U. S. War Veteran,
X
19
At 1 2: 55
RECEIVED
TOWN
11 12
S
6
-
MAY 1 G
M R-301A 1
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
Registered No.
98
Winthrop Community Hospital
No.
Lillian G. Flanagan
RF,
(If deceased is a married, widowed or divorced woman, give also maiden name.)
410 Shirley Street
(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
50
4 days. In place of residence .years. .months. .days.
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
MAY (Month)
3
(Day)
1955 (Year)
55
I last saw
h ER alive on
MAY
3
195, death is said to
have occurred on the date stated above, at
1:45Pm.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE
70
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.
East Boston
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
William Fraser
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Canada
19 MAIDEN NAME
OF MOTHER
Ellen Lawlor
20 BIRTHPLACE OF MOTHER (City) (State or country) Canada
21 Informant (Address)
Charles.Flanagan 410 Shirley St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
(Signature of Agent of Board of Health or other)
5/5/50
(Official Designation) v
(Date of Issue of Permit) V.E
-
9 COLOR OR RACE
8 SEX
Female
White
10 SINGLE
MARRIED
WIDOWED
or DIVOREDried
(write the word)
10a If married, widowed, or divorced
HUSBAND of ..
(Give maiden name of wife in full)
(or) WIFE of
Charles A. Flanagan
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) CEREBRAL HEMORRHAGE
3 DAYS
ANTE CEDENT (b) CAUSES
Due To HYPERTENSIVE HEART DIS
2 YRS.
Due TO ARTERIO-SCLEROTIC HEART DIS (c)
RT.
OTHER
SIGNIFICANT
CONDITIONS
Dr. VENTRICULAR TACHYCARDIA
5 WAYS.
Major findings:
Of operations.
NONE
Date of operation
NONE
Was autopsy performed? No.
What test confirmed diagnosis ?.
CLINICAL
5 Was disease or injury in any way related to occupation of deceased ?...
If so, specify
myrou n. Kurz
M. D.
(Signed)
(Address) 272 PLEASANT ST. WINTHERDate MITY 3 1955
-
6 Holy Cross
Malden Mass
Place of Burial or Cremation (City or Town) 19.55
May 6
DATE OF BURIAL.
7 NAME OF
FUNERAL DIRECTOR.
Culture
O'nealei
ADDRESS
Winthrop Mass MAY 60 1955
Received and filed
19
(Registrar)
PARENTS
50M-5-52-907046
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, > neans 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.
X
To be filed for burial permit with Board of Health or its Agent.
J(If death occurred in a hospital or institution,
St. [ give its NAME instead of street and number)
2 FULL NAME
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
MEDICAL CERTIFICATE OF DEATH
4 I HEREBY CERTIFY, JAN 53
19
to .. MAY 3
That I attended deceased from
3YRS.
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 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.
the deceased, furnish for registration a standard certificate of death, stating to the: cof persons as are supposed to have died by violence, or by the action of
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- cemetery or burial ground in which the interment is made.
diate cause of death as nearly as he can state the same. For neglect to camply - 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 6 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 i ( 1) 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 6 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 hoard 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 -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 7 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 Jot the funeral is to he held, or from a person appointed to have the care of the
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, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
A R-301A 1
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
No.
287 Revere St
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.
Registered No. 99
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
287 Revere St
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
MAY
(Month)
(Day)
4
1955.
(Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDMarried
4 I HEREBY CERTIFY.
MAY 13
1952
to MAY 4,
1955
I last saw h. E.R .alive on
MAY 3, 1952 death is said to
have occurred on the date stated above, at.
4:30 P.m.
INTERVAL BE- TWEEN DNSET AND DEATH
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) ...
GENERALIZED.
CARCINOMATOSis
6 MOS
12
44
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.
Thorndike
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
Francis Vilson
18 BIRTHPLACE OF
FATHER (City)
Ware
Date of operation.
MAY 20, 1912 Was autopsy performed?
No.
(State or country)
Mass
What test confirmed diagnosis?
CLINICAL + LABORATORY
5 Was disease or injury in any way related to occupation of deceased ?..
If so, specify.
(Signed) Maurice Traunchin
(Address) 62 SHIRLEY JE, WINST Date MAY 4
140
6
Vinthrop
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
May 7
19
55
7 NAME OF
FUNERAL DIRECTOR
autumn TO males
ADDRESS
Winthrop/Mass
Received and filed MAY 6 1955 19
(Registrar)
PARENTS
19 MAIDEN NAME
OF MOTHER
Janet Russell
20 BIRTHPLACE OF
19.5.5.
MOTHER (City)
Worcester
(State or country)
Mass
21
Informant
John H. Collins
(Address) 287 Revere 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 & Laker, (Signature of Agent of Board of Health or other)
Health oficer 5/5/56
(Official Designation)
(Date of Issue of Permit)
V
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
John H. Colling
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
ANTE
Due To CARCINOMA RIGHT
CEDENT (b)
CAUSES
BREAST
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
NONEST
Major findings:
ADENOCARCINOMA RY. BREAST
Of operations.
M. D.
Vinthrop
100M-10-53-910621
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.
id conditions. ing rise to the e (a) stating lying cause
tions contrib- e death but not the disease or causing death.
PHYSICIAN - IMPORTANT
Violet I. Collins
1.
(Was deceased a
U. S. War Veteran.
if so specify WAR)
(a) Residence.
No.
(Usual place of abode)
3
6
That I attended deceased from
3 YRS.
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.
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 toldd 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; £14. 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.
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 hen mperson who. though disabled by recognized disease unrelated to any form of injuryhave died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(2) Board of Health physicians will certify to such deaths only as those of
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
X
PLACE OF DEATH
Suffolk (County)
REVENE.
6-3 50
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial pormit with Board of Health or its Agent.
Registered No.
100
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME .. Caroline M. Faucon (Cornelissen)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
144 Pradstreet
Avg. , Revere, Mass.
(If nonresident, give city or town and State)
Length of stay: In place of death
.years
months.
3
days. In place of residence.
.years.
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
(Month)
(Day)
6
1955
(Year)
8 SEX
female
9 COLOR OR RACE
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
widowed
4 I HEREBY CERTIFY,
That I attended deceased from
1955
to
1955
I last saw hy
alive on
my 5, 1951, death is said to
have occurred on the date stated above, at
3= A. m.
INTERVAL BE-
TWEEN ONSET AND DEATH 11 IF STILLBORN, enter that fact here.
AGE
.78
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:
15 Social Security No.
none
16 BIRTHPLACE (City)
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