USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 32
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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. 012-20-7468
16 BIRTHPLACE (City)
(State or country)
Cambridge
Mass
17 NAME OF
FATHER
David Gaddis
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHER
Sarah Dixon
20 BIRTHPLACE OF MOTHER (City) (State or country) Ireland
21
Informant
StanleyC . Healy
(Address) 19 Parkman Road Reading Mass. I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued:
Mass.
(Sigfrature of Agent of Board of Health or other)
Health Ofrecer
4/25/58
(Official Designation) (Date of Issue of Permit)
UCTIONS OF CERTIFICATE
giving OF DEATH it enter han one for each b) and (c)
es not mean of dying, heart failure, lc. It means , or compli- hich caused
is, if any, ive rise to ause (a), the under- ause last.
ons contrib. eath but not the terminal udition given
Chapter 137, 354, requires is to print or cause or death on ctifcates.
50M·5-57-920345
-1*
No .. 85 Sunnyside Avenue
To be filed for burial permit with Board of Health or its Agent.
(Was deceased a
U. S. War Veteran,
if so specify WAR).
NO
(Usual place of abode)
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 rule's 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
X -
R-301A 1
PLACE OF DEATH
JUFFÜLIT. (County) WINTHROP. (City or Town) 71 READ ST
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.
83
$ (If death occurred in a hospital or institution,, St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT
L
(Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residence. No. 11 READ ST St
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death 57 years. months. days. In place of residence 5 years. months. .days.
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
FEMALE
9 COLOR
WHITE
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
WIDOWED
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of.
CHARLES O. GUNDERSEN
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGES6 Years
.Months.
.. Days'
If under 24 hours
-
.Hours.
Minutes
13 Usual
HOME !' ... .. MY
(Kind of work done during most of working life)
14 Industry
or Business :
15 Social Security No. AUNE
16 BIRTHPLACE (City)
(State or country)
MASS
17 NAME OF
FATHER
UNKNOWN 100.000
18 BIRTHPLACE OF
FATHER (City)
ST MELO
(State or country)
FRANCE
19 MAIDEN NAME
OF MOTHER
UNKNOWN
20 BIRTIIPLACE OF
MOTHER (City)
(State or country)
IRELAND
MRS HELEN HANDFORD
21
Informant.
(Address)
11 REAU ST WINTHROP
I HEREBY, CERTIFY that a satisfactory standard certificate of death was Klech with me BEFORE the burial or transit permit was issued: Table C. Pereaux (Signature of Agent of Board of Health er other)
4/25/56
Official Designation)
(Date of Issue of/Perniit)
WBV
CTIONS JR ERTIFICATE
iving F DEATH : enter ian one or each ) and (c)
es not mean of dying, art failure, c. It means > . or compli- !ich caused
s, if any, ve rise to use (a), he under. use last.
ms contrib- ath but not the terminal dition given
OTHER
SIGNIFICANTArterio Selerotic Heart
CONDITIONS
Disease
4 yrs
Was autopsy performed ?.
What test confirmed diagnosis? Clinical
5 Was disease or injury in any way related to occupation of deceased? No If so, specify.
(Signed)
M. D. (Address) Winthrop, Muss Date Y/25/ 1958
6 WOODLAWN
EVERETT
(City or Town)
Place of Burial or Cremation DATE OF BURIAL APRIL 26 195
7 NAME OF FUNERAL DIRECTOR ADDRESS ZILWINTHROPST WINTHROP
Received and filed. APR 25 1958 19
(Registrar.)
INTERVAL BETWEEN ONSET AND DEATH 2 days
(b) Arteriosclerosis
10 yrs
Due To (c)
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
April
24,
1958
(Month)
(Year)
(Day)
4 I HEREBY CERTIFY,
That I attended deceased from
April 17
1958
to
April 24
1958
I last saw h.p.v.alive on
April 23, 1958 death is said to
have occurred on the date stated above, at 3:30 A.m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE (a) Cerebral Hemorrhage.
GUNDERSEN
2 FULL NAME.
No. MARY T (POULET
(If deceased is a married, widowed or divorced woman, give also maiden name.)
Registered No.
EAST BOSTON
PARENTS
(write the word)
Occupation :
Chapter 137, 54, requires to print or cause or death on ifcates.
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- tern, 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, O. 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
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. 84
St. [give its NAME instead of street and number) No. Winthrop Community Hospital
2 FULL NAME. THOMAS F SEXTON
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 33 Bateman Ave Revere
St.
(If nonresident, give city or town and State)
Length of stay: In place of death.
years.
months
6-1 days. In place of residence 5 0
. years
months 4 _. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
APRIL
28
1958
(Month)
(Day)
(Year)
4I HEREBY CERTIFY
AUGUST
APRIL
LS
That I attended deceased from
50
I last saw h Zalive on
APRIL
ZE
195
, death is said to
have occurred on the date stated above, at
9.30P
.m.
INTERVAL BETWEEN ONSET AND DEATH
DDYS
PERSONAL AND STATISTICAL PARTICULARS
8 SEX male
9 COLOR
white
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
10a If married, widowed, or divorced
Correta
Perreault
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 7.1 Years.
Months
Days
If under 24 hours
Hours ....... Minutes
13 Usual
Occupation :
Retired
(Kind of work done during most of working life)
14 Industry
Kevere Fire Dept.
or Business:
15 Social Security No.
011-26-8957
16 BIRTHPLACE (City)
(State or country)
Mass.
17 NAME OF
FATHER
Thomas Sexton
18 BIRTHPLACE OF
Charlestown
FATHER (City).
(State or country)
Mass.
19 MAIDEN NAME
OF MOTHER
Mary Murphy
20 BIRTHPLACE OF
MOTIIER (City)
(State or country)
Charlestown Mass.
21 Loretta Sexton
Informant
(Address)
33 Bateman Ave, Revere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
Hereand.L
(Signature of Agent of Board of Ilealth of pthier)
·
4/30/56
(Registrar)
5 YRS
Due To (c)
OTHER
DUODENAL ULLER
SIGNIFICANT
CONDITIONS
Was autopsy performed?
What test confirmed diagnosis?
iVU 2KG
5 Was disease or injury in any way related to occupation of deceased? A/C If so, specify .....
(Signed).
Haroto Musgrave
(Add
,
M. D.
570 Beuch V, Parece
4-28
Date
6 Holy Cross
Place of Burial or Cremation
Malden (City or Town)
DATE OF BURIAL
May 1
19 58
7 NAME OF
FUNERAL DIRECTOR
ADDRESS
A Lire Will
Revere
APR 30 1958
19
Received and filed
SOM-5-57-920345
-301A 1
TIONS
RITIFICATE ing
DEATH enter in one tr each and (c)
not mean of dying, 't failure, It means or compli- h
caused
if any, rise to (a), under- last.
contrib- eh but not " terminal ion given
Capter 137, requires R. so print or cause or death on cates.
PARENTS
[(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR).
no
(Usual place of abode)
to
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(2) ANTERIOR INT. INFARCTION
Due To GENERALIZE ARTERIGOSLAR
(b)
Charlestown
(Official Designation) 10
(Date of Issue of Permit)
To be filed for burial permit with Board of Health or its Agent.
TEVERE 5-8-58
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registercd 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 dicd, 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 nincteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
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