USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 38
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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
100M-10-53-910621
7 NAME OF
FUNERAL DIRECTOR.
ADDRESS 523 Brody Chelsea
Received and filed. 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX mule
9 COLOR OR RACE
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Durand
4 I HEREBY CERTIFY,
That I attended deceased from
February
1953
MAY 24
1955
I last saw h wl alive on
May 24
1955
death is said to
have occurred on the date stated above, at
11.30 A.
m.
INTERVAL BE- TWEEN ONSET AND DEATH 5 years
11 IF STILLBORN, enter that fact here.
69
12
AGE .Years
7
.Months .. 28 Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation :
Fireman (retired)
(Kind of work done during most of working life)
14 Industry
Strafford County Farm
or Business:
15 Social Security No ..
003-18-
2563
Dover
16 BIRTHPLACE (City)
(State or country)
nett
GUPPY
17 NAME OF
FATHER
albert Gapey
18 BIRTHPLACE OF
FATHER (City)
Dover
(State or country)
n. Hampshire
19 MAIDEN NAME
OF MOTHER
Rhoda a Berry
20 BIRTHPLACE OF
na Elva Mccarthy
21
Informant.
(Address)
68 Chester ave chelsea
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter A- 10 aveiro
(Signature of Agent of Board of Health or other)
3/29/55
(Official Designation)
(Date of Issue of Permit)
.
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a) Rheumatic Heart Disease
ANTE
Due To
CEDENT (b)
CAUSES
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations
Date of operation
Was autopsy performed?
No
What test confirmed diagno
Physical Examination
5 Was disease or injury in any way related to occupation of deceased? NO
If so, specify .... 1;
J albert Kart
M. D.
ofthe HILL Cem over n.M. Place of Burial or Cremation (City or Town) DATE OF BURIAL June 1 1955
F9. MEGLincher
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS Book
To be filed for burial permit with Board of Health or its Agent.
STANDARD Dep. #45 Registered No. 110
CERTIFICATE OF DEATH
Winthrop Concalesent Home
J(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number) No. HENRYM GUREL HENRY M. GUPPY PHYSICIAN - IMPORTANT 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
106 Williams
St.
Chelsea
(Was deceased a
U. S. War Veteran,
if so specify WAR)
no
(a) Residence. No. (Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ..... .. years. months~ days. In place of residence. 20 years months ... ... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
MAY
29
1955
(Month)
(Day)
(Year)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Ethel M. Bailey
(or) WIFE of
(Husband's name in full)
[ R-301A -
38
38.1
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure. asthenia, ns the disease. cations which th
d conditions. ing rise to the e (a) stating lying cause
ions contrib death but not he disease or ausing death.
(Signed)
(Address) [ Crescent Ave Cles Date 2424
1955
MOTHER (City)
West
Powell
(State or country)
Maine
PARENTS
Winthrop (City or Town) PLACE OF DEATH SUFFOLK (County)
Chelsea- 6-8-55
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.
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 immer 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-stx 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 ha
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.
A physician or officer furnishing a certificate of death as required by the No undertaker or other persons shall bury a human body or the ashes thereof preceding section or by section forty-five of chapter one hundred and four t E heh 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 of 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).
11 1 2 RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1)Atfending physicians will certify to such deaths only as those of persons whom they have given bedside care during a last illness from disease unrelated dennform of injury.
Board of Health physicians will certify to such deaths only as those of ersons, who ;- though disabled by recognized disease unrelated to any form of osury have died without recent medical attendance or whose physician is absent Lomlhome 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 received a permit from the board of health or its agent aforesaid or from the cler fur's or poisonthermal, 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
1
ORGANIZATION AND OUTFIT
SERVICE NUMBER
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
To be filed for burial permit with Board of Health or its Agent.
111
2 FULL NAME.
Catherine A. Haugh
(If deceased is a married, widowed or divorced woman, give also maiden name.)
86 Bellevue Ave.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ...... 30 ... years. 4 months. days. In place of residence years months .days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
may
29
1955 (Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDrried
4 I HEREBY CERTIFY.
That I attended deceased from
mar 20 1955 19. to ... MAY 29 55
I last saw h.E.R.
.alive on
MAY 29
19.
death is said to
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
John J. Haugh
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
Broncho pneumonia.
TWEEN ONSET AND DEATH 5-26-5
11 IF STILLBORN, enter that fact here.
69
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:
Qmn Home
15 Social Security No.
16 BIRTHPLACE (City).
(State or country)
Ireland
OTHER
SIGNIFICANT
CONDITIONS
Major findings:
Of operations.
NIME
Date of operation
NINE
Was autopsy performed?
What test confirmed diagnosis ?.
5 Was disease or injury in any way related to occupation of deceased?
If so, spe
V. Thomas
Haffer
M. D.
19 50
Winthrop
Winthrop (City or Town)
DATE OF BURIAL.
June 1
19.55
7 NAME OF
FUNERAL DIRECTOR
antico Domates
ADDRESS Winthrop .... Mass
JUN 1
Received and filed 19
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Catherine Mortimer
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21 Informant. Mary .... A .... Haugh
(Address)
86 Bellevue Ave Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Walter f Haber (Signature of Agent of Board of Health or other)
5/3/130
(Official Designation)
(Date of Issue of Permit)
RUCTIONS FOR CERTIFICATE giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure, asthenia. ns the disease, cations which th.
id conditions. ing rise to the e (a) stating lying cause
tions contrib- death but not he disease or ausing death.
100M-10-53-910621
No.
Winthrop Community Hospital
J(If death occurred in a hospital or institution.
St. [ 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)
(Month)
(Day)
have occurred on the date stated above, at 5200 m.
INTERVAL BE-
ANTE
CEDENT (b)
CAUSES
Due To CEREBRALThrombosis
5-2260
Due To GEN. ARTERIOSCLEROSIS
(c)
yrs.
17 NAME OF
FATHER
Thomas Tarmey
(Signed) (Address) 29 Bref HEL Date May 20
6 Place of Burial or Cremation
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, Char2 58.(Soci 6g 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).
9.
-3RULES 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)JUdita) Examiner 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
7
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
No.
227 Shirley Street
..... ......
J(If death occurred in a hospital or institution,
St. Į give its NAME instead of street and number)
2 FULL NAME John Robert Sandiford
(If deceased is a married, widowed or divorced woman. give also maiden name.)
(a) Residence. No. 227 Shirley Street
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. 35 ... years
.. months
days. In place of residence
35.
.years
.months
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
May .... 29,1955
(Month)
(Day)
(Year)
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.
9:55 Pm.
INTERVAL BE- TWEEN ONSET AND DEATH
11 IF STILLBORN. enter that fact here.
12
AGE ..... 7.2Years
1
Months .. 25 Days
If under 24 hours
Hours .. . Minutes
13 Usual
Occupationretired custodian
(Kind of work done during most of working life)
14 Industry
Winthrop .Co-Operative Bank
or
15 Social Security No ......
030-03-7967-4
Barbadoes
16 BIRTHPLACE (City) ..
(State or country)
British West Indies
17 NAME OF FATHER Richard Sandiford
18 BIRTHPLACE OF
FATHER (City)
Barbadoes
(State or country)
British West Indies
19 MAIDEN NAME
20 BIRTHPLACE OF
(State or country) British West Indies
21 Informant Mr.s ..... John R. Sandiford
(Address)
227 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:
Watter
G Baker
(Signature of Agent of Board of Health or other) HO.
may 31/55
(Official Designation)
(Date of Issue of Permit)
RUCTIONS FOR CERTIFICATE
giving OF DEATH ot enter than one for each (b) and (c)
does not mean of dying, such lure, asthenia, ns the disease, cations which th.
d conditions, ing rise to the e (a) stating lying cause
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