Town of Winthrop : Record of Deaths 1958, Part 72

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

USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 72

Note: The text from this book was generated using artificial intelligence so there may be some errors. The full pages can be found on Archive.org (link on the Part 1 page).

I HEREBY CERTIFY thatja satisfactory standard certificate of death was filed with me HBFORE the burial or transit permit was issued : Halkle C. Sercaune X (Signature of Agent of Board of Health of other)

Thelatele Officer

10/16/58

(Official Designation )

(Date of Issue of Perniit)

R-301A 1

CTIONS JR ERTIFICATE

iving F DEATH : enter an 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.

's contrib. ath but not he terminal dition given

Chapter 137, 54, requIres 3 to print or cause or death on

Ificates.

PLACE OF DEATH

(City or Town)

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

(If death occurred in a hospital or institution,,

St. { give its NAME instead of street and number)

PHYSICIAN - IMPORTANT

(Was deceased a

U. S. War Veteran,

if so specify WAR)

Mass

Boston

(If nonresident, give city or town and State)

If under 24 hours

AGE

Years

5 min.

Ellenville

PARENTS

(Address)

100M.11.55.916:45

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 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

......

- Sutolles (County)

WinTheop (City or Town) P13: 33YENI & 80-5-11

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.

202

BAY View Nursing HOME No

+ Washington AGE.

NORMAN YETER MAC WHinDIE

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

10A Madison AVE

St.

WAKEfield

(a) Residence. No.

(Usual place of abode)

Length of stay: In place of death.

years months 21 days. In place of residence

.. years.

months ..

.days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

THURS

OCT

16.19.58

(Month)

(Day)

(Year)

4 I HEREBY CERTIFY,

That I attended deceased from

S'EFT 26

OCT 16

I last saw h.) Malive on

OCT 16

19.30, death is said to

have occurred on the date stated above, at

3500 P

DEATH WAS CAUSED BY: IMMEDIATE CAUSE

(a)

Due To

CARCINOMA OF LEFT

(b)

LUNG

15 mg

Due To (c)

OTHER

SIGNIFICANT

CONDITIONS

NONE

Was autopsy performed?

What test confirmed diagnosis? Gurgay July 1957

5 Was disease or injury in any way related to occupation of deceased? No If so, specify

(Signed) gowan h Ring M. D. (Address)-PLEASANT The Date. 00/17 1955

6 CALVARY E. WoBURN MASS Place of Burial or Cremation (City or Town)

DATE OF BURIAL

OCT20,

1958

7 NAME OF

FUNERAL DIRECTOR.

HARold A MEMann

ADDRESS 32 Richardsen Av& wakefield Palky C. Pereanung

Received and filed OCT 17 1958 19

(Registrar)

PERSONAL AND STATISTICAL PARTICULARS

8 SEX

MALE

9 COLØR

WHITE

10 SINGLE

(write the word)

MARRIED

WIDOWED

Widowed

10a If married, widowed, of

HUSBAND of ....

STheR

Gallagher

(Give maiden name of wife in full)

(or) WIFE of

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

AGE 56.

Years.

10 Months.

Days"

If under 24 hours

Hours ........ Minutes

13 Usual

Occupation :

MilkMAN

14 Industry

or Business:

Milk Dairy Co.

15 Social Security No ....

020-07-0353

16 BIRTHPLACE (City)

(State or country)

NOVA SCOTIA

17 NAME OF

FATHER

Albert MAUWhinniE

18 BIRTHPLACE OF

NOVA SCOTIA

FATHER (City)

(State or country)

19 MAIDEN NAME

OF MOTHER

Annie MuisE

20 BIRTHPLACE OF

MOTHER (City).

(State or country)

NOVA SCOTIA

21 MRS Edward F. GRACE JR.

Informant

(Address)

10A Madison AVE, WARofall

I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:

(Signature of Auent 7of Board of Health or Scher

Health Price 10/17/08

( Official Designation ) (Date of Issue of Permits

CTIONS R ERTIFICATE iving F DEATH ; enter an 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 usc (a), he under. use last.

ms contrib. ath but not he terminal dition given

Chapter 137, 54, requires s to print or cause death on ifcates.

100M.11.55-916145

PLACE OF DEATH

R-301A 1

Registered No.

S(If death occurred in a hospital or institution,,

St. ¿ give its NAME instead of street and number)

PHYSICIAN - IMPORTANT (Was deceased a

U. S. War Veteran,

if so specify WAR)

None

(If nonresident, give city or town and State)

GENERAL CARCINOMATESIS

INTERVAL BETWEEN ONSET AND DEATH 3 MO.

(Kind of work done during most of working life)

VARMOUTH

PARENTS

2 FULL NAME

to ..

EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH

A physician or officer furnishing a certificate of death as required by the preceding section or hy 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.

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.

. 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, 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.

SPACE FOR ADDITIONAL INFORMATION

DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING

ORGANIZATION AND OUTFIT

SERVICE NUMBER

.......

PLACE OF DEATH

(County)

(City or Town)

CONudeCENT

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.

203

2 FULL NAME

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

(a) Residence. No.

24 Sea Foam Ave.

(Usual place of abode)

St ..

Winthrop

(If nonresident, give city or town and State)

Length of stay: In place of death ........... years .........

months ..

11 days. In place of residence.

34 years.

.months

.days.

MEDICAL CERTIFICATE OF DEATH

3 DATE OF

DEATH

October

1958

(Year )

(Month)

(Day)

4 I HEREBY CERTIFY

That I attended deceased from

April

1956,

to .....

Oct. 10,

1958

I last saw he.V.alive on

Oct1

..... 195%, death is said to

have occurred on the date stated ahove, at Si45A.m. INTERVAL BETWEEN DEATH WAS CAUSED BY: IMMEDIATE CAUSE ONSET AND DEATH 6/2yrs.

Due To (b)

Due To (c)

OTHER

SIGNIFICANT

CONDITIONS

None.

Was autopsy performed?

What test confirmed diagnosis Clinical and pathological

5 Was disease or injury in any way related to occupation of deceased? No If so, specify.

(Signed).

Chaplin Liberman

M. D.

OF MOTHER

Sarag ( c.n.b.1)

(Addre

Winthrop, Mass Date 10/21/1958

Jewish Peoples. Fuller St. Everett (City or Town

Place of Burial or Cremation

DATE OF BURIAL. 10-22- 58 19

7 NAME OF

B. Schlossberg & Sons

FUNERAL DIRECTOR

ADDRESS.

1257 Blue Hill Ave. Matt.

Received and filed

OCT 21 1958

(Registrar)

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.

Harry Goober

(Husband's name in full)

11 IF STILLBORN, enter that fact here.

If under 24 hours

AGE

Years

Months ............ Days

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 ...........

none

16 BIRTHPLACE (City)

(State or country)

Russia

17 NAME OF Jacob.

FATHER

Kranetz

PARENTS

18 BIRTHPLACE OF

FATHER (City)

(State or country)

Russia

19 MAIDEN NAME

20 BIRTIIPLACE OF

MOTHER (City).

(State or country)

Russia

21 Harry Goober

Informant

(Address)

24 Sea Foam Ave. Winthrop

Heath

I HEREBY CERTIFY that a satisfactory standard certificate of

was filed with me BEFORE the burial or transit permit was issued:

Malble De Jureannet 8

P( Signature of Agent of Hours of Health or eher)

(Hebeltto Officer 10/21/58 (Official Designation) (Date of Issue of Permit)

11.L

TIONS

ERTIFICATE

ving DEATH enter an one r each and (c)

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

, if any, e rise to Asc (a), e under- se last.

ns contrib- th but not se terminal ition given

hapter 137, 4, requires to print or cause or death on ficates.

100M· 11.55.916145

-301A 1 Winthrop

Mounts Nursing Home No ..

Bertha Goober

$ (If death occurred in a hospital or institution,,

St. { give its NAME instead of street and number)

PHYSICIAN - IMPORTANT

(Was deceased a

U. S. War Veteran,

if so specify WAR)

MARRIED

WIDOWED married

or DIVORCED

(a)

Carcinoma

of Colon

......

Registered No.

EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE

RETURN OF CERTIFICATES OF DEATH

A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.

A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- 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.

Need help finding more records? Try our genealogical records directory which has more than 1 million sources to help you more easily locate the available records.

Town of Winthrop : Record of Deaths 1958, Part 72

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

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