USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1955 > Part 79
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death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate. shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G, L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases 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, 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).
RECERULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice: TO 1.
(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.f
(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) thernial,ior 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 HROB.
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)
Bos ton
(City or Town) St. Elizabeth's
8 pt.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Bos ta (City or town making return) 239 10630
Registered No.
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.)
92 Plummer Ave.
Winthrop
Mass .
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.
........ years.
months. 20 days.
In place of residence 44
.. years.
.months.
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
(Month)
(Day)
(Year)
8 SEX
F
9 COLOR OR RACE
W
10 SINGLE
(write the word)
MARRIED
WIDOWED Married
or DIVORCED
4 I HEREBY CERTIFY.
Oct. 24
19
55
Nov. 21
19
death is said to
have occurred on the date stated above, at.
3:35PM
.. m.
INTERVAL BE-
TWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
AGE 45
4
Years
Months
22
Days
If under 24 hours
Hours
Minutes
3 Week $3 Usual
Occupation :.
Housewife
(Kind of work done during most of working life)
14 Industry
or Business:
At Home
15 Social Security No.
None
16 BIRTHPLACE (City)
(State or country)
Swampscott
OTHER
Acute suppurative
SIGNIFICANT
tracheo bronchitis bilateral
parotitis
1 Week
Major findings:
Of operations.
Fibroid ... uterus;intest.obst.
Date of operation
.Was autopsy performed ?.
Yes
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased ?.. N.O. If so, specify "J"E"Doherty
(Address).
St. Eliz. Hospt.
Date
11 .... 2219.
M. D.
5$
Winthrop Cem-Winthrop Mass.
Place of Burial or Cremation (City or Town)
DATE OF BURIAL
Nov.25/55
19
7 NAME OF
FUNERAL DIRECTOR
H S Reynolds
Winthrop Mass.
ADDRESS
Received and filed
NOV 30 1935
19
(Registrar of City or Town where deceased resided)
PARENTS
17 NAME OF
FATHER
George Merrill
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Moncton N. B.
19 MAIDEN NAME
OF MOTHER
Ellen Swimm
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Prince Edward Island
Franklyn C McNaught
A TRUE COPY Kanlen 21 Zwack.
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Nov. 28/55
.19
-
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
Franklyn C'McNaught
(or) WIFE of.
(Husband's name in full)
DISEASE OR CONDITION
DIRECTLY LEADING
Post oper ative
intestinal obstruction
TO DEATH (a)
ANTE
Due To
CEDENT (b)
CAUSES
Due To
(c)
3 DATE OF DEATH (Signed). 6 25M-5-55-915025 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 after the close of the month in which the death occurred. (See Chap. 46, Sec. 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, CONDITIONS
M R-302 1
No.
Lillian McNau ght
(Was deceased a
U. S. War Veteran,
if so specify WAR)
(a) Residence. No. (Usual place of abode)
Nov. 21/55
That
I attended deceased
from
55
I last saw h ....
er ... alive on
to.
Nov. 211. 55
WRITE PLAINLY, WITH UNFAVING BLACK INK - THIS IS A PERMANENT RECORD
m.S.
21
Informant
(Address)
OF TOOL
1
3
...
6"5
HROP. .
NOV30
PLACE OF DEATH
Suffolk (County)
R-301A 1 Winthrop
(City of Town) 88 Winthrop Street No.
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.
240
J(If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Mae Dorothy (Reid) Raynard
(If deceased is a married, widowed or divorced woman, give also maiden name.)
88 Winthrop Street
St.
(If nonresident, give city or town and State)
(a) Residence. No. (Usual place of abode) 4 4 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
(Month)
(Day)7
4 I HEREBY CERTIFY.
That I attended deceased from
can. 1950 to ... Nov. 23, ... 1955
I last saw
h.@ ... .... alive on.
Nov. 23
195's death is said to
(or) WIFE of.
Alton J Raynard
(Husband's name in full)
11 IF STILLBORN. enter that fact here.
58 0
12
AGE
Years
Months
12 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 ..
None
Halifax
16 BIRTHPLACE (City) (State or country) Nova scotia
OTHER
SIGNIFICANT
CONDITIONS
None.
Major findings:
Of operations
Date of operation
.Was autopsy performed? No
What test confirmed diagnosis ?.
Clinical
5 Was disease or injury in any way related to occupation of deceased?
If so,
(Signed).
(Address) Winthrop Class Date 11/24/1955
M. D.
6 Winthrop
Place of Burial or Cremation
DATE OF BURIAL
19.55
7 NAME OF
FUNERAL DIRECTOR
Howard 5 Minods
ADDRESS.
Winthrop muss
JOV 25 1.
19
(Registrar)
PARENTS
17 NAME OF FATHER Caleb Reid
18 BIRTHPLACE OF
FATHER (City)
St John
(State or country Newfoundland
19 MAIDEN NAME OF MOTHER Selina Miller
20 BIRTHPLACE OF MOTHER (City) St John (State or countryNewfoundland
21 Alton J Raynard Informant .88 Winthrop 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 & Hakes (Signature of Agent of Board of Health or other)
Thealte 14
(Official Designation)
(Date of Issue of Permit)
X
UCTIONS OR CERTIFICATE
iving F DEATH t enter han one or each ) and (c)
oes not mean dying, such ure, asthenia, is the disease, tions which
conditions, tg rise to the (a) stating ying cause
ons contrib- death but not e disease or using death.
100M-10-53-910621
Received and filed.
You.
23
1955
(Year)
8 SEX
Female
9 COLOR OR RACE
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Married
10a If married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
have occurred on the date stated above, at.
3:00 P.m.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a)
ANErebral Hemorrhage
TWEEN ONSET AND DEATH 1 day.
ANTE
Ittypextensive- Cerebral
CEDENT (b)
CAUSES
Vascular Disease
5yrs.
Du To Left Hemiparesis
(c)
5yrs.
Winthrop (City or Town)
Nov . 26
(Address)
ature Mich
11/25 /55
1
(Was deceased a U. S. War Veteran, if so specify WAR)
PHYSICIAN - IMPORTANT
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 hy 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 ninetcen 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, 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, 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
No. PLACE OF DEATH SUFFOLK (County) Winthrop (City or Town)
PASTOR 12.500
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. 241
Registered No.
[(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.)
251 Princeton (a) Residence. No. (Usual place of abode)
St.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
EAST Boston
(If nonresident, give city or town and State)
None
Length of stay: In place of death 2 years.
months. days. In place of residence .years .months .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Mou 24 1955
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY. for. six ... 19
to .. 124
I last saw h
h .. alive on
nowy 1955
death is said to
have occurred on the date stated above, at. 9 A .m.
DISEASE OR CONDITION DIRECTLY LEADING TO DEATH (a) Arteriosclerosis
INTERVAL BE- TWEEN ONSET AND DEATH 2 mm
ANTE CEDENT CAUSES (b) Due To DEGENERATive DISEASE LUMBAR SPINE
Due To MYO CARdiAL-INFAR CTION. (c)
OTHER SIGNIFICANT CONDITIONS
CARDIAC FAILURE
+ 1 day
Major findings:
Of operations.
Date of operation.
Was autopsy performed?
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
It so, specify ......
(Signed)
andren Cato
M. D.
(Address) 602 Broadway.Men
Date For . 2.5- 19:5
Holy CROSS Place of Burial or Cremation
Malden (City or Town)
DATE OF BURIAL Nov 280 1953
7 NAME OF
R Fredenle Muugratta
FUNERAL DIRECTOR
ADDRESS FASE B6stol
NOV 25 750.
Received and filed 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
MAle
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
OLEARY
Kwrite the word) Widowed
10a
If married, wid ged
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
73
,AGE
Years
Months
Days
If under 24 hours
Hours
Minutes
13 Usual
Occupation:
Longshoreman (Kind of work done during most of working life)
14 Industry
or Business:
Retired
15 Social Security No ...
022-10-8895
16 BIRTHPLACE (City)
(State or country)
New Foundland
17 NAME OF
FATHER
John J. Walsh
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Newfoundland
19 MAIDEN NAME
OF MOTHER
Not Known
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21 Informant MARY GORMAN (Address) 251 Princeton ST. EBosta
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: batter A: Haberz. (Signature of Agent of 'Board of Health of other)
Health Officer 11/25/55
(Official Designation) (Date of Issue of Permit)
1
-
TRUCTIONS FOR L CERTIFICATE
i giving OF DEATH not enter , than one · for each (b) and (c)
; does not mean of dying, such silure, asthenia. sans the disease. lications which ath.
bid conditions, ving rise to the ese (a) stating erlying cause
itions contrib- he death but not the disease or causing death.
50M-5-52-907046
2/
brech
That I attended
deceased from
Winthrop Convalescent Home John'tJ. PSNAPSONT SI 1
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 hy 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 1 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 Chap. 114, Sec. 46, G. L., (Tercentenary Edition). 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-severr. of said chapter one hundred and fourteen, the word "war" shall include the China". RULES OF PRACTICE relief expedition and the Philippine insurrection, which shall, for said purposes, be The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice: deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border (1) Attending physicians will certify to such deaths only as those of persons service of nineteen hundred and sixteen and nineteen hundred and seventeen to whom they have given bedside care during a last illness from disease unrelated 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, untilhe ury have died without recent medical attendance or whose physician is absent
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
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