Town of Winthrop : Record of Deaths 1958, Part 45

Author: Winthrop (Mass.)
Publication date: 1958
Publisher:
Number of Pages: 566

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 45

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SPACE FOR ADDITIONAL INFORMATION

DATE OF ENTERING MILITARY SERVICE

DATE OF DISCHARGE RANK, RATING

ORGANIZATION AND OUTFIT

SERVICE NUMBER

...........

JUN -41958 CM

THAT

11.12

RECEIVED 11 ١٢٠

X 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. 116

Mount Rest Home 104 Highland Ave St. [give its NAME instead of street and number) No ..

2 FULL NAME Mary Donahue (Davis)

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence. No. 1 Vallar Rd East Boston St Boston

(Usual place of abode)

(If nonresident, give city or town and State)

Length of stay: In place of death 1 years months days. In place of residence 5 years. months. days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

JUNE

(Month)

1958

(Year)

(Day)

4 I HEREBY CERTIFY, That I attended deceased from

JANUARY

1957

JUNE

I last saw heRalive on

MAY

, 1958, death is said to

have occurred on the date stated above, at

8:45 Am.

DEATH WAS CAUSED BY: IMMEDIATE CAUSE

(a)

CORONARY THROMBOSIS

INTERVAL BETWEEN ONSET AND DEATH

SUDDEN

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

9 COLOR

10 SINGLE

(write the word)

Female White

10a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of.

Bernard Donahue

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

75 Years

Months

2 Days

If under 24 hours

... Hours ..... Minutes

13 Usual

Occupation :

Housewife

(Kind of work done during most of working life)

14 Industry

or Business :

At Home

15 Social Security No.

Cannot be learned

16 BIRTHPLACE (City)

(State or country)

Massachusetts

17 NAME OF

FATHER

Emanuel Davis

Was autopsy performed?

What test confirmed diagnosis ?.

5 Was disease or injury in any way related to occupation of deceased ? If so, specify.

(Signed)

Francis P. Schaffen

M. D.

(Address)

104 Bennington ST. E.B.

· June 4 1958

6 Holy Cross Malden

Place of Burial or Cremation

DATE OF BURIAL

June 6

1958

(City or Town)

7 NAME OF

FUNERAL DIRECTOR.

Richard C.Kirby

ADDRESS

917 Bennington St East Boston

Received and filed

JUN. 4 1058

(Registrar)

PARENTS

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Portugal

19 MAIDEN NAME

OF MOTHER

Emelia Machado

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

Portugal

George Donahue

son

1 HEREBY CERTIFY that a satisfactory standard certificate of death was filed with my BEFORE the burial or trauisit permit was issued :

(Signature of Agent,of Board of Health or other)

1-10

6/ 4/58

(Official Designation)

(Date of Issue of Permit)/

01A

FICATE

EATH ter one ach d (c)

t mean dying, failure, means compli- caused

any, ise to (a). under- last.

ontrib. but not terminal given

er 137, equires rint or or

ise th on tes.

50M-11-56-918978

Due To

HYPERTENSIVE

(b)

HEART DISEASE

Due To (c)

OTHER SIGNIFICANT CONDITIONS

1/2 yRs.

To be filed for burial permit with Board of Health or its Agent.

[(If death occurred in a hospital or institution,

Winthrop

PHYSICIAN - IMPORTANT

(Was deceased a U. S. War Veteran, if so specify WAR).

MARRIED

WIDOWED

or DIVORCED

Widowed

Boston

Informant

(Address)

330 Meridian Street E Bostor

1205/020 6-12-55

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 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, eightcen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and ninetcen hundred and seventeen. G. L. Chap. 46. Sec. 10.

No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the sclectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the

death certificate contains a recital, as required by. section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).

Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. .. - General Laws, Chap. 38, Sec. 6., as amended by Chap. 632, Sec. 4, Acts of 1945.

No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.

Chap. 114, Sec. 46, G. L .. (Tercentenary Edition).

RULES OF PRACTICE

The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:

(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.

(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.

(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.

Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.

Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.

SPACE FOR ADDITIONAL INFORMATION

DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING. ORGANIZATION AND OUTFIT

SERVICE NUMBER

JUN - 41958 PM

11 12

11:300

RECEIVE

PLACE OF DEATH

X SUFFOLIT. (County) WINTHROP (City or Town) 53 CREST AVE

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.

117

$(If death occurred in a hospital or institution,, St. { give its NAME instead of street and number)

AGNES R (REYNOLDS) WHARTON

2 FULL NAME

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence. No ... (Usual place of abode)

53 CREST HAVE St

(If nonresident, gi

city or town and State)

days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

June

1958

(Year)

(Month) (Day)

4 I HEREBY CERTIFY,

That I attended deceased from

19 to.

I last saw h ........ alive on

death is said to

have occurred on the date stated above, at

DEATH WAS CAUSED BY: IMMEDIATE CAUSE

(a)

Due to

Due

I natural causes,

presumably coronary

Due To occlusion. (c) Winthrop Board of Health

OTHER SIGNIFICANT CONDITIONS Charles Liberar, mil

Was autopsy performed? What test confirmed diagnosis ?

5 Was disease or injury in any way related to occupation of deceased? If so, specify .......

(Signed)

@leadles Lebenun

M. D.

(Addr Winthrop

Date ...

6/10/

1958

HOLY CROSS 6

MALDEN

Place of Burial or Cremation (City or Town)

DATE OF BURIAL JUNE 12 195A

7 NAME OF

FUNERAL DIRECTOR

ADDRESS 216 WINTHROP ST WINTHROP

Received and filed.

JUN 10-1958 19

(Registrar)

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

FEMALE

9 COLOR

WHITE

10 SINGLE

MARRIED

WIDOWED

or DIVORCED

(write the word)

WIDOWED

(or) WIFE of ..

10a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

WILTON G WARTEN

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGEÇ 2 Years

Months.

Days®

If under 24 hours

Hours ........ Minutes

13 Usual

Occupation :

HOME WIFE

(Kind of work done during most of working life)

14 Industry

or Business :

HUME

15 Social Security No ..

16 BIRTHPLACE (City).

(State or country)

17 NAME OF

FATHER

JOHN REYNOLDS

18 BIRTHPLACE OF

FATHER (City)

NY CITY

(State or country)

19 MAIDEN NAME

OF MOTHER

JULIA MULCAHEY

20 BIRTHPLACE OF

MOTHER (City)

NY CITY

(State or country)

JOHN WHARTON

21 Informant (Address) 131 RUSSELL ST EVERETT.

I HEREBY CERTIFY that a satisfactory standard certificate of death Myas filed with me BEFORE the burial or transit permit was issued : Talkle Jereama (Signature of Agepy of Board of Health or other)

Chealth Offert

6/10/08

(Official Designation)

(Date of Issue of Permit)

V.F. V

R-301A 1

TIONS R ERTIFICATE

ving DEATH enter an one or each and (c)

s not mean of dying, rt failure, . It means or compli- ich caused

, if any, e rise to use

(a), e under- use last.

ns contrib. ath but not he terminal dition given

chapter 137, 54, requires to print or cause death on Ificates.

100M.11.55.016145

PARENTS

Registered No.

PHYSICIAN - IMPORTANT

(Was deceased a

U. S. War Veteran,

if so specify WAR)

Length of stay: In place of death 15 years. months. days. In place of residence 32 years. months.

INTERVAL BETWEEN ONSET ANO DEATH

- (b)

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- 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.

(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include hot 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.

SPACE FOR ADDITIONAL INFORMATION

DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING

ORGANIZATION AND OUTFIT.

SERVICE NUMBER

......

PLACE OF DEATH

Suffolk (County)

LEVER 6-12-58

BostonWINTHROP (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.

118

Mayflower Nursing Home No.

2 FULL NAME

Leah Levy

(Lipschitz)

(If deceased is a married, widowed or divorced woman, give also maiden name.)

(a) Residence.

No.

538 Beach

(Usual place of abode)

St.

Revere , Mass.

(If nonresident, give city or town and State)

Length of stay: In place of death 34

32 years

months

days. In place of residence28

years .....

months .......... days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

June

(Month)

(Day)

10th

1958

(Year)

4 I HEREBY CERTIFY,

That Lattended deceased from

March 1904

Janne 10", 19/58

I last saw helalive on

June 9

, 1958, death is said to

have occurred on the date stated above, at

5=A m.

DEATH WAS CAUSED BY: IMMEDIATE CAUSE

(a) FulminatiNG Virus Ineune

Due To

+ Parkinson's Disease

(b)

Due To

· Senility

(c)

OTHER

SIGNIFICANT

CONDITIONS

Was autopsy performed?

What test confirmed diagnosis ?__

5 Was disease or injury in any way related to occupation of deceased ? If so, specify

(Signed)

Louro Siegel

, M. D.

(Address)

22 Shirley Ave

Date. 6/10 1958

Kaminker

Travere (Lebanon) Revere

Place of Burial or Cremation

DATE OF BURIAL

(city of Town)FILE

June 12, 19 58

7 NAME OF

FUNERAL DIRECTOR

Benjamin F.Solomon

ADDRESS

420 Harvard Street, Brookline.

Received and filed

JON 11.1958

(Registrar)

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

female

9 COLOR

white

10 SINGLE

(write the word)

MARRIED

WIDOWED

or DIVORCEDWidowed

10a If married, widowed, or divorced

HUSBAND of

(Give maiden name of wife in full)

(or) WIFE of

Abraham Levy

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGE

Years

Months

Days

If under 24 hours

Hours .._ Minutes

13 Usual

Occupation :

(Kind of work done during most of working life)

14 Industry

or Business:

15 Social Security No ...

none

New York.

16 BIRTHPLACE (City)

(State or country)

N.Y.

17 NAME OF

FATHER

Abraham Lipschutz

PARENTS

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Poland

19 MAIDEN NAME

OF MOTHER

£x Hannah (unknown)

20 BIRTHPLACE OF

MOTHER (City)

(State or country)

England

21 Sadie Burnim

Informant

(Address)

10 Walnut Avenue, Revere, Mass.

I HEREBY CERTIFY that a satisfactory, standard certificate of death was filed with me BEFORE the burial or transit permit was issued: ralph 6 Jereannex Signature of Agent of Board of Health or otherf

6/11/58

(Official Designation) (Date of Issue of Pcrmit)

-301A 1

TIONS R RTIFICATE

ring DEATH enter in one r each and (c)

not mean of dying, rt failure, It means or compli- ch caused

if any, rise to se

s contrib- - th but not he terminal ition given

pter 137, requires o print or cause or death on cates.

SOM-11-56-918978

Registered No.

f(If death occurred in a hospital or institution, St. [give its NAME instead of street and number) -

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Town of Winthrop : Record of Deaths 1958, Part 45

Author: Winthrop (Mass.) Publication date: 1958 Publisher: Number of Pages: 566

Author: Winthrop (Mass.)
Publication date: 1958
Publisher:
Number of Pages: 566