USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1956 > Part 2
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT
SERVICE NUMBER
·
A R-302 1
PLACE OF DEATH
Suffolk (County) Chelsea
(City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
Chelsea
(City or Town making this return)
6
1
Soldiers' Home Hospital No.
§(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Leland G.Floyd
(If deceased is a married, widowed or divorced woman, give also maiden name.)
18 Villa Ave.
Winthrop, Mass
St
(a) Residence. No Hosobre tarde)
(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
3 DATE OF
DEATH
Jan. 7,1956
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
Dec.30
1955
to
Jan. 7
19.56.
I last saw himlive on
Jan .. 7
156., death is said to
have occurred on the date stated above, at
6:10px
... m.
INTERVAL
BETWEEN
ONSET AND
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Acute myocardia infarction DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEMarried
10a If married, widowed, or divorced
HUSBAND of
Jeannette Young
(Give maiden name of wife in full)
(or) WIFE of ..
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
60
11
16
If under 24 hours
AGE
Years.
Months.
Days
Hours ........ Minutes
13 Usual
Occupation :
Bookkeeper
14 Industry
or Business:
not known
15 Social Security No .......
.not ..... known
16 BIRTHPLACE (City)-Winthrop, Mass. (State or country)
17 NAME OF
FATHER
Charles P.
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Winthrop, Mass.
19 MAIDEN NAME
OF MOTHER
Eda Richardson
20 BIRTHPLACE OF
MOTHER (City)
Winthrop Cemetery Winthrop Mass . (State or country) Brooklyn, N.Y.
Place of Burial or Cremation
(City or Town) Jan . 11,1956 19
7 NAME OF
FUNERAL DIRECTOR
Alfred B. Marsh
ADDRESS.
174 Winthrop St. Winthrop
Received and filed.
FEB 8 1950
19
(Registrar of City or Town where deceased resided)
PARENTS
(Signed)
Eleanor S.Wang
(Address)
M. D.
Soldiers' Home
Date.
1/7/56
19
50M .: 1-55.916145
Due To (b) 6 resided as soon as possible, after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.) at the time of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town Due To (c)
OTHER
Chronic bronchial asthma
SIGNIFICANT
CONDITIONS
Was autopsy performed?
ho
What test confirmed diagnosis ?.
clinical
5 Was disease or injury in any way related to occupation of deceased ? If so, specify
DATE OF BURIAL
21 Informant. Hospital Records
(Address)
A TRUE COPY Joseph a. Tyrrell
ATTEST:
(Registrar of City or Town where death occurred)
DATE FILED
Jan. 7,1956
19
VIV
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
Registered No.
(Was deceased a
WWI
U. S. War Veteran,
if so specify WAR)
(Kind of work done during most of working life)
RECEIVED
TO
1
1
6 5
FEB-3
1
Enlisted 2/14/15 Discharged 6/6/19 Pvt. 1/c Co. 101st Inf. 62890
X
PLACE OF DEATH
(County) Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or Its Agent.
· Registered No. .... 5
curante To Winthrop Community (es) death No. Ulysses for Hamilton 2 FULL NAME.
St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, no if so specify WAR)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 44 Buchanan St. Wintherote
(If honresident, give city or town and State)
Length of stay: In place of death ............ years. .. months .days. In place of residence
40
.years
months ..
.days.
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
l'ale
10 COLOR OR RACE
White
11 SINGLE
MARRIED
WIDOWED married
or DIVORCED
11a If married, widowed,of divorced
Stella Dean
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
acute Palinción Dedama
12 IF STILLBORN, enter that fact here.
13
AGE
64 Years
2
Months
21
Days
If under 24 hours
.Hours ........ Minutes
14 Usual
Occupation :.
Truck Driver
(Kind of work done during most of working life)
15 Industry
or Business:
Town of Winthrop
16 Social Security No.
019-12-0062
17 BIRTHPLACE (City) ... East .... Boston
(State or country)
Massachusetts
18 NAME OF
FATHER
UnknownAmaziali Hamilton
19 BIRTHPLACE OF
FATHER (City).
(State or country)
Maine
20 MAIDEN NAME
OF MOTHER
Unknown
Ellen & Murray
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
Unknown
Halifax
In.S.
22 Mrs. Stella Hamilton
Informant
(Address)
L.L. Buchanan 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 S Bakery.
(Signature of Agent of Board of Health or other)
1/9/56
(Registrar)
PARENTS
...
M. D.
(Address) Date an-9-1956
(City or Town) 1956
8 NAME OF
FUNERAL DIRECTOR
Ernest P Caggiano
ADDRESS 147 Winthrop St., Winthrop
Received and filed.
Jan, 10, 1956
19
1956
( (Year)
4I HEREBY CERTIFY that I have investigated the death of the person above-named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Its par tanzen Heat Vicence
(a) Residence. No. (Usual place of abode) MEDICAL CERTIFICATE OF DEATH 3 DATE OF DEATH Jan - 8- (Month) (Day) 5 Accident, suicide, or homicide (specify) Date and hour of injury 19 Where did Injury occur? (City or town and State) (Specify type af place)/ Injury Nature of (How, did injury ogcur?) Injury (Signed) 7 Winthrop Cemetery ... Winthrop Place of Burial, or Cremation. DATE OF BURIAL January 11. of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH In plain terms, so that It may be properly classified under the International Classification of Causes Information should be carefully supplled. MEDICAL EXAMINERS should stato CAUSE AND MANNER OF While at work? ? Was autopsy performed?
SOM-10-53-910621
71.5.
RM R-303 A 1
MARGIN RESERVED FOR BINDING
Every Item of N. B. - WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
Did injury occur in or about home, on farm, in industrial place, or in public place?
6 Was disease or injury in any way related to occupation of deceased ?.
Unknown
Easthart
(write the word)
HUSBAND of
occurred in a hospital or institution,
(Official Designation) (Date of Issue of Permit)
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 eause 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, See. 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 eaused 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. See. 45. G. L. as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931. No undertaker or other person 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 elerk 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 eare of the cemetery-or burial ground in which the interment is made ......... Chap. 114. Sec. 46, G. L., as amended.
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, Aets of 1945.
The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULE'S 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 diseaseiresulting 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a steam railway accident.""Pistol shot wound of the chest with associated hemorrhage, hom- icidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1)Under eause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
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
Suffolk (County)
Winthrop
No.
(City of Town) uva/content 142 Pleasant St
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH Horne
To be filed for burial pormit with Board of Health or its Agent.
6
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. 81 Sunnyside Ave
St.
(If nonresident, give city or town and State)
4
months days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
January 8, 1956
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY.
That I attended deceased from 11/14/53 19 1/8 5% 10º
I last saw h
alive on
1/8/56 19
death is said to
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
68
Years
Months.
Days
If under 24 hours
.. Hours ......
Minutes
13 Usual
Occupation :
Operator
(Kind of work done during most of working life)
14 Industry
or Business:
M. T.A. Railway
15 Social Security No.
16 BIRTHPLACE (City). (State or country)
Ireland
17 NAME OF
FATHER
Dennis O'Brien
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Mary Minihane
20 BIRTHPLACE OF MOTHER (City) (State or country)
Ireland
21 Informant ing Charles Williams (Address)] Sunnyside 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 A. lakers. (Signature of Agent of Board of Health or other) Healthe Office 1/10/56
(Official Designation)
(Date of Issue of Permit>
X
10a If married, widowed, or divorced
Nora Dea
HUSBAND of
(Give maiden name of wife in full)
have occurred on the date stated above, at.
INTERVAL BE-
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH
(a)
.
BSPONCHO PNEUMONIA
5 DAYS
ANTE
Due To CHRONIC MYOCARDITIS
CEDENT (b)
CAUSES
Due To (c)
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 to occupation of deceased?
If so, specify ......
(Signed) the 10 Vegan MIT
(Address) 070Sureto,75513 Date 1/4/14 19
M. D.
6 Mt. Calvary
Place of Burial or Cremation
Boston Magg (City or Town)
DATE OF BURIAL. January 11. 1956
7 NAME OF FUNERAL DIRECTOR Arthur J. O'Maley
ADDRESS Winthrop Mass
Received and filed. JAN10 1956 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR OR RACE
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEbi dowed
(write the word)
(Usual place of abode)
Length of stay: In place of death .. years 3 months. .days. In place of residence .years.
2 FULL NAME.
Dennis M. O'Brien
(If deceased is a married, widowed or divorced woman, give also maiden name.)
100M-10-53-910621
J.
TRUCTIONS FOR L CERTIFICATE
n giving OF DEATH not enter e than one se for each , (b) and (c)
s does not mean e of dying, such failure, asthenia, eans the disease, lications which eath.
bid conditions. iving rise to the use (a) stating derlying cause
ditions contrib- the death but not o the disease or causing death.
PARENTS
... to ..... ,
TIẾP
m.
TWEEN ONSET AND DEATH
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 it's 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.
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