USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 31
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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
X
PLACE OF DEATH
Suffolk (County)
Winthrop, Mass. (City of Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burlal permit with Board of Health or its Agent.
110 Grovers Ave. Winthrop, Mass.
St. [give its NAME instead of street and number) No.
2 FULL NAME
Hettie Cornwell
Barton
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 110 Grovers Ave. Winthrop, Nass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death 46
years
months
days. In place of residence46
years
months
days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
3 DATE OF
DEATH
apriil (Month)
20, (Day) 1958 (Year)
8 SEX Female
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
Widowed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
William E. Barton
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
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
16 BIRTHPLACE (City) Union Springs, New York (State or country)
17 NAME QE FATHERGeorge Bustin
18 BIRTHPLACE OF
England
FATHER (City) (State or country)
19 MAIDEN NAMHettie Cornwell OF MOTHER
20 BIRTHPLA Union Springs, New York MOTHER (City) (Statc or country )
21 Informant TO (Address)
Mrs.Lorle J.Waldo (Daughter) Grovers Ave . Winthrop
Mass
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 Health or other)
4/21/08
(Registrar)
PARENTS
Forest Hills Crematory-Boston, Mass. Place of Burial or Cremation [City or Town)
DATE OF BURIAL
April 22,1958 19
7 NAME OF
FUNERAL DIRECTOR
I.S. Waterman
ADDRESS
Boston , Mass
Received and filed APR 22 1958
19
SOM-11-56-916978
R-301A 1
;TIONS R RTIFICATE ving F DEATH enter an one ır each ) and (c)
s not mean of dying, art failure, It means or compli- ch caused
if any, · rise to use (a), e under- use last.
is contrib- - ath but not he terminal Dition given
OTHER SIGNIFICANT CONDITIONS
200
Was autopsy performed?
What test confirmed diagnosis
Clinical Signs
5 Was disease or injury in any way related to occupation of deceased ? If so, specify A 220
(Signed) winthrop Date 4-70 1952
M. D.
(Address)
C
19.1.3 to. april 20 19 ...
I last saw h QYalive on aprilia, 1956, death is said to
have occurred on the date stated above, at 9:20 p.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a) Myocarditis
(Seule)
Due To
- (b)
4
IHEREBY CERTIFY
That I attended deceased from
Registered No.
80
[(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT -
(Was deceased a
U. S. War Veteran,
NO
if so specify WAR)
(Official Designation) (Date of Issue of Pofmit)
.
INTERVAL
BETWEEN
ONSET AND
DEATH
12
92
AGES
years
Years
6
Months
3
Days
Due To (c)
lapter 137, 5, requires to print or cause fdeath on t cates.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
de of tł br di
cc
01
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.
P1 t€ a1 e1 sł di w F. of re de nı
in ha su
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
re ot re of sh a re m la pl er 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 aj 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 ca pe tc P th TE re fc 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.
S SPACE FOR ADDITIONAL INFORMATION
I DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
I RANK, RATING
( ORGANIZATION AND OUTFIT.
§ SERVICE NUMBER
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.
se
G G. L. Chap. 46, Sec. 10. 0
X
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.
81
St. (give its NAME instead of street and number) No .. Winthrop Community Hospital
2 FULL NAME Harry Nathen Bangs
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
155 Winthrop St.
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. years. months 14 days. In place of residence 60 years. months. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
APRIL
(Month)
(Day)
21
1958
(Year)
4 I HEREBY CERTIFY,
JAN
52
That I attended deceased from
to.
APRIL 21
58
I last saw h/alive on
APRIL 21, 1958, death is said to
have occurred on the date stated above, at
4.45
.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
UREMIA -
(a)
Due To CEREBRAL HEMMURHAGE (b)
È LEFT HEMIPLEGIA
14 DAYS
Due To
ARTERIOSCLEROSIS AND
(c)
ARTERIO-SCLEROTIC HEART DAS
syes.
OTHER
SIGNIFICANT
CONDITIONS
NONE
Was autopsy performed?
No.
What test confirmed diagnosis? CLINICAL
5 Was disease or injury in any way related to occupation of deceased? NO If so, specify
(Signed)
Kupon n. Kung
1
M. D.
(Addr 222 PLEASANT ST
WINTERTO Datelipc 21
1958
6 Winthrop Cemetery Winthrop, Mass Place of Burial of Cremation (City or Town)
DATE OF BURIAL April /24, 1958
7 NAME OF
FUNERAL DIRECTOR
Walked B.March
ADDRESS 174 Winthrop St. Winthrop,
Received and filed APR 24 1958 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
male
white
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED widowed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
Helen MacDonalofein full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 86
Years.
8 Months 20 Days
If under 24 hours
Hours ..... Minutes
13 Usual
Occupation :
retired mover
(Kind of work done during most of working life)
14 Industry
household furnishings
15 Social Security No. 022-12-0103
Durham
16 BIRTHPLACE (City)
(State or country)
llaine
PARENTS
17 NAME OF
FATHER
Harry Nathanial Bangs
18 BIRTHPLACE OF
FATHER (City)
Durham
(State or country)
Maine
19 MAIDEN NAME
OF MOTHER
Frances Newell
20 BIRTHPLACE OF
MOTHER (City)
Durham
(State or country)
Maine
21
Informant
(Address)
Allan C. Bangs 159 winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
Mass
(Signature of Ageof of Board of Health or other) Health Hacer
(Official Designation)
U
424/58
(Date of Issue of Vermit)
TIONS
TIFICATE
Ing DEATH enter n one each and (c)
not mean dying, failure, It means r compli- caused
if any, rise to (a). under- last.
contrib .- but not terminal tion given
pter 137, requires print or or :ath on fites.
50M-11.56-918978
-301A 1
Registered No.
[(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
(Was deceased a
NO.
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
INTERVAL
BETWEEN
ONSET AND
DEATH
10 DAYS
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 he 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
1 } S T
C I
1
C 5
1
1
1 €
1
1
S
-
( 1 ( 1
€ دي
(
M
1
(
(
1
1 1
T
-
X
R-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No. 82
J(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
2 FULL NAME
(If deceased is a mafi
(a) Residence. No.
85 Sunnyside Avenue
St.
(If nonresident, give city or town and State)
Length of stay: In place of death. .years months. days. In place of residence .......... years. months ..... .... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
22
1958
(Year)
(Month)
(Day)
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
11:15 Am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Natural Causes
INTERVAL
BETWEEN
ONSET AND
DEATH
(b)
Due To
Presumably Coronary
Occlusion
hours
(c)
· Arteriosclerotic Heart
Disease
years
OTHER
SIGNIFICANT
CONDITIONS
None
Was autopsy performed?
No
What test confirmed diagnosis? Clinical
5 Was disease or injury in any way related to occupation of deceased? No If so, specify .... . arthur C. Murray , M. D. Winthrop Board of Health Date 23 April 1958
PARENTS
6 Mt. Pleasant Cemetery Arlington, Mass Place of Burial or Cremation (City or Town)
DATE OF BURIAL __. April 25 1958 19
7 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
174 Winthrop St. Winthrop,
Received and filed APR 25 1958 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED Widowed
or DIVORCED
female
white
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
James Hanter Healy
11 IF STILLBORN, enter that fact here.
12
AGE69
Years
8
Months 27
Days
If under 24 hours
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