USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1957 > Part 21
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(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 death's following abortion, but also deaths from disease resulting from injury of 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. HAR 2-21957 FM
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
1 -
-
-
-
-
1
-
PLACE OF DEATH
Suffolk (County)
CINSE FETT
winthrop (City or Town)
No. 9.6 .... "pland
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.
59
S (If death occurred in a hospital or institution,, Rct { give its NAME instead of street and number)
2 FULL NAME. James 7. Sharkey
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ....
96 Upland
(Usual place of ahode)
Bst
(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
March
21
1957
DEATH
(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 ahove, at
9:25 P.
m .
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Natural Causes
INTERVAL BETWEEN ONSET AND DEATH
-
yrs
(c)
Generalized Arterio-
Sclerosis
yrs
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
no
What test confirmed diagnosis ?.
clinical
5 Was disease or injury in any way related to occupation of deceased? no If sorSpecifyn.
Arthur @ Murray M. D. Anthrop Board of Health, March 1957
6 Toly Cross
"'alden
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL. "arch 23,
7 NAME OF
Arthur S. forcella
ADDRESS 876 anthrop Avc., Revere
Received and filed MAR 22 1957. 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
single
10a If married, widowed, or divorced 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
AGE
77 Years.
Months ........
... Days
If under 24 hours
Hours .....
Minutes
13 Usual
Occupation :
Ret. Clerk
(Kind of work done during most of working life)
14 Industry or Business :
15 Social Security No ....
none
16 BIRTHPLACE (City) (State or country) ass.
Boston,
17 NAME OF FATHER Bernard Sharkey
18 BIRTHPLACE OF FATHER (City). (State or country) Ireland
19 MAIDEN NAME
OF MOTHER
Marcaret Campbell
20 BIRTHPLACE OF MOTHER (City). (State or country)
Joseph J. Gallagher
21
Informant
(Address)
06 [pland 3d., inthrop, LONG
2
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
(Signature of Agent of Board of Ilcalth or other)
3/22/57
(Official Designation ) /
(Date of Issue of Permit)
CTIONS R
ERTIFICATE Iving F DEATH enter an one or each ) and (c)
es not mean of dying, art failure, . It means or compli- ich caused
s, if any, e rise to usc (a), e under- use last.
ns contrib- ath but not he terminal dition given
Chapter 137, 54, requires s to print or cause or death on tificates.
100M-11-55-916145
R-301A 1
Y
-
Due
(b)
Disease
· Arteriosclerotic Heart
PARENTS
Ireland
Registered No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
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- te ·n, shall. if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45. G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. .- General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits. or if there is no such board, 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 deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, 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
MAR 2 21957 PM
6
11.12
V
E OF TOWN
RECEIVEN
ERK
PLACE OF DEATH
(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 filled for burial permit with Board of Health or its Agent.
60
Community HanIf ( If death occurred in a hospital or institution, JA St. (give its NAME instead of street and number) No. 38 GR LUinthROP Bigwood, Harold Smith PHYSICIAN - IMPORTANT
(If deceased is a married, widowed or divorced woman, give also maiden name.)
30 GROVERS
Ave .
St.
(If nonresident, give city or town and State)
Length of stay: In place of death ... years. months 1 days. In place of residence .. 4 .years
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
MARRIed
10a If married, widowed, or divorced
HUSBAND of FLORENCE
LYONS
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 56 Years
5 Months 22 Days
If under 24 hours
Hours ...... Minutes
13 Usual
Occupation :
Shipper
(Kind of work done during most of working life)
14 Industry
Studios Fre.
or Business:
15 Social Security No 010-28-1618
FieRett
16 BIRTHPLACE (City)
(State or country)
MASS
17 NAME OF
FATHER
Benjamin F. Bigwood
18 BIRTHPLACE OF
FATHER (City)
Manchester
(State or country)
MASS
19 MAIDEN NAME
OF MOTHER
Ada JANE Smith
Rockport
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
MASS.
21 Informant
(Address)
30 Levere Que Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death wag filed with me BEFORE the burial or transit permit was issued : Jackle Jereally
Signature of Ageut of Board of lhealth or other)
Health precie
ふえてって
(Official Designation)
(Date of Issue of P'ermit)
X
R-301A 1
CTIONS R ERTIFICATE
ving DEATH enter an one or each and (c)
s not mean of dying. art failure, . It means or compli- ich caused
,if any, e rise to use
(a), e under- use
last.
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
NONE
Was autopsy performed ?.
No.
What test confirmed diagnosis? PATHOLOGICAL.
5 Was disease or injury in any way related to occupation of deceased /6 If so, specify
(Address)
(Signed)
myron 1. King
M. D.
22 Pleasant ST Walter Bate 3/22 1957
6
Rosedale Cemetery
Manchester
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
MARCH
.2.5
1957
7 NAME OF
FUNERAL DIRECTOR
Mary &, Match.
ADDRESS
79 Weet Footer off Melhores
Received and filed
MAR 22 1957
19
(Registrar)
2V
1957
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
MAR 21
19
57
to
MAR
22
1957
I last saw h/Malive on
:
MAR21
, 19J:2, death is said to
have occurred on the date stated above, at
905Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
GENERAL CARCINOMATOSIS
(a)
INTERVAL BETWEEN ONSET AND
DEATH 6 MO.
Due To
CARCINOMA OF PROSTATE
(b)
TBLADDER
1 YR
SOM-5-56-91 7573
2 FULL NAME
(a) Residence. No ..
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
MAAR
(Month)
(Day)
Registered No.
(Was deceased a
U. S. War Veteran,
if so specify WAR).
No
months.
days.
PARENTS
Barvy Harold A. Nigeral
is contrib- - th but not he terminal ition given
hapter 137, 4, requires to print or cause death on ficates.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician. if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, 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 in jury, have died without recent medical attendance pr 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, of electrical agents, and deaths following abortion, but also deaths from disease resulting from injury prinfection related to occupation, the sudden deaths of persons nøt 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.
MAR 2 21957 PM
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
1
X
PLACE OF DEATH
SUFFOLKC (County)
R-301A 1 WINTHROP (City or Town) 361 SHIRLEY
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.
61
[(If death occurred in a hospital or institution. St. [ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME.
SARAH CHAFETZ
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 361 SHIRLEY
St.
(If nonresident, give city or town and State)
(Usual place of abode) Length of stay: In place of death 12 .. years. months days. In place of residence.
12,
.years
months
.days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
FEMALE
9 COLOR OR RACE
WHITE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
WIDOWED
4 I HEREBY CERTIFY.
That I attended deceased from
July
1952
to.
March 23. 1957
I last saw ther alive on March 23, 19 5%, death is said to
have occurred on the date stated above, at
6:00 A.m.
INTERVAL BE- TWEEN ONSET
DISEASE OR CONDITION
DIRECTLY LEADING
TO DEATH (a) Acute Coronary
Occlusion
AND DEATH 24hrs
ANTE
Coronary Artery
CEDENT (b)
CAUSES
Heart Disease
Due
· Arteriosclerosis
(c)
OTHER
SIGNIFICANT
CONDITIONS
None.
Major findings:
Of operations.
None,
Date of operation
Was autopsy performed? NO.
What test confirmed diagnosis ?.
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