USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1959 > Part 3
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1
n giving OF DEATH not enter e than one 1 se for each , (b) and (c)
does not mean ode of dying s heart failure, , etc. It means case. or compli- which caused
tions, if any, gave rise to cause (a), & the under- cause last.
ditions contrib to death but not to the terminal condition given .
:- Chapter 137, f 1954, requires ians to print or the cause or of death certificates.
CHAP. 46, 55 9 & CHAP. 114 $$ 45, CHAP. 38$ 6.)
7 NAME OF
FUNERAL DIRECTOR
alfred B. March
ADDRESS
774 Winthrop St. Winthrop,
Received and filed
JAN 23 1959
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
10 SINGLE
(write the word)
MARRIED
married
WIDOWED
or DIVORCED
male
white
mathilda
Lilliefors
10a If married, widowed,or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
Due To
GENERAL ARTERIOSCLEROSIS
(b)
1 YR.
and
Due To
ARTERIO-SCLEROTIC HEART
(c)
DIS.
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)
nuran 3. King
M. D.
(Address) 222 PLEASANT ST. Date 1/23
WINTERSte.
6 Woodlawn Cemetery Everett,Mass. Place of Burial or Cremation (City or Town)
DATE OF BURIAL ..
January 240 205919
6 mi?
PARENTS
MR-301A
.- THIS IS A NENT RECORD Use only E APPROVED ink or black writer ribbon.
TRUCTIONS FOR AL CERTIFICATE
nel jurisdiction
medical Examiner
M-10-58-923886
1
No. 64 Bates Avenue
PHYSICIAN - IMPORTANT
(Was deceased a
NO.
U. S. War Veteran,
if so specify WAR)
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT SERVICE NUMBER
...
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 RECEIVED 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.
C TOM
11.12
OLE
JAN 2 31959 FM
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 filled for burial permit with Board of Health or its Agent.
8
[(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).
no
(If deceased is a married, widowed or divorced woman, give also maiden name.)
-6 Pico ive.
St
(If nonresident, give city or town and State)
Length of stay: In place of death.
.. years.
months: 14
days. In place of residence ....... years.
months.
....... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
JAN
(Month)
23 1959 (Day) (Year)
8 SEX
9 COLOR
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
4 I HEREBY CERTIFY
MAR
1950
to
JAN 23
59
I last saw h/Aflive on
JAN
23
19
death is said to
have occurred on the date stated above, at
330 A.m.
INTERVAL BETWEEN ONSET AND DEATH 12 4 DAYS AGE 7 8Years .. .Months ........ Days
If under 24 hours
Hours ....... Minutes
13 Usual
Occupation:
Echanic ( RET . )
(Kind of work done during most of working life)
14 Industry
or Business:
building blevators
15 Social Security No.
wct known
okurn
16 BIRTHPLACE (City)
(State or country)
17 NAME OF
FATHER
John Higgins
18 BIRTHPLACE OF
St. John
N. E.
FATHER (City).
(State or country)
19 MAIDEN NAME
OF MOTHER
Woburn
Mary Torrens
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
MUSS.
21 Elizabeth d. higgins
Informant
(Address)
16 Pico Eve Winthrop, dass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Halkle C: Tereanur.2 (Signature of Agent of Board of Health or other) Health Officer 1/23/59
(Official Designation)
(Date of Issue of Permit)
TRUCTIONS FOR IL CERTIFICATE
n giving , OF DEATH not enter e than one se for each , (b) and (c)
does not mean de of dying. i heart failure, , etc. It means rase. or compli- which caused
tions, if any, gave rise to cause (a), the under- cause last.
ditions contrib -- o death but not to the terminal condition given
· Chapter 137, ! 1954, requires ans to print or the cause or death on certificates.
50M-11-56-918978
7 NAME OF
FUNERAL DIRECTOR
Maurice ". Kirby
ADDRESS winthrop
JAN 23 1959
19
(Registrar)
PARENTS
6 Calvary
Hoburn
Place of Bur al or Cremation
Jan.56
199
(City or Town)
DATE OF BURIAL
M. D. 22 PLEASANTIN FILTRO Date 1/23 1959
(Addr
Was autopsy performed? No. EKG + CLINICAL
What test confirmed diagnosis?
5 YRS.
(c)
Due To
GENERAL ARTERIOSCLEROSIS
5YRS.
10YRS.
5 Was disease or injury in any way related to occupation of deceased NO If so, specify
(Signed)
OTHER
CHRONIC BRONCHITIS
SIGNIFICANT
CONDITIONS
(b)
Due To
ARTERIO-SCLEROTIC
HEART DISEASE
That I attended deceased from
10a If married, widowed, or divorced
LifeMeth a. Jones
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
ACUTE MYOCARDIAL
INFARCTION
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
2 FULL NAME
John C. Higgins
Registered No.
Winthrop Com. Hosp.
No.
(a) Residence.
No.
(Usual place of abode)
Received and filed
MR-301A 1
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 imine- 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 forfcit 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 he 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 reinoval 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. See. 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 su:ldenly 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 ahuman 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 dlerk of the town where the body is to be buried or the funeral is to he 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).
PEPI RULES OF PRACTICE -KAT
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice: 0 1 (1) Attending physicians will certify to such.deaths only as those of persons to whom they have given bedside care, during Nast illness front disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who. though disahled by recognized disease unrelated to any forin of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examinersmall Investigate and, certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by Ytanmatism (including resulting\sentiremnia), andby 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
certificate pideaty
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 yearsor over. If the occupa- .thon 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
1
١١٠٢٢
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.
41 Washington Ave., (Bay View Nursa fy death occurred in a hospital or institution. No.
2 FULL NAME Winifred G. Brawley (Leonard)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
912 Shirley Street, Winthrop St.
(If nonresident, give city or town and State)
Length of stay: In place of death years 6 months days. In place of residence.
14 years.
..... months ......... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
January 24
(Month)
(Day)
1959 (Year)
8 SEX
Female White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Widowed
4 I HEREBY CERTIFY,
That I attended deceased from
July
19
50
, to 24 January
1959
I last saw heralive on
19 January, 1959, death is said to
have occurred on the date stated above, at
2 A. Mm.
INTERVAL
BETWEEN
ONSET ANO
DEATH
11 IF STILLBORN, enter that fact here.
12
AGE 78 Years.
5
Months
17Days
If under 24 hours
Hours.
Minutes
13 Usual
Occupa
(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)
Mass
17 NAME OF
FATHER
John Leonard
Was autopsy performed?
no
What test confirmed diagnosis?
X-ray; Surgery 1953
5 Was disease or injury in any way related to occupation of deceased? no If so, specify ......
M. D. dressy Muchroß May Date 2 4 Jan 195g
Mt. Benedict/Cemetery, Boston 6
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
January 26th
19
59
7 NAME OF
FUNERAL DIRECTOR
Richard C. Kirby
ADDRE
917 Bennington St. ,E.Boston
Received and filed
MAN 20-1959 19
(Registrar)
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Boston
Mass.
19 MAIDEN NAME
OF MOTHER
Mary Heffernan
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston
Mass.
21
Informant
Mrs. Harriett C. Ronan-Dau
(Address) 25 Birch Rd, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Tireauna
(Signature of Agent of Board of Health or other)
Health Officer
1/25/59
(Official Designation)
(Date of Issue of Permit)
TRUCTIONS FOR .L CERTIFICATE
n giving OF DEATH
not enter e than one se for each , (b) and (c)
does not mean de of dying, heart failure, etc. It means ose, or compli- which caused
ions, if any, gave rise to couse (a), the under- couse lost.
Due
Carcinoma of Breast
(b)
5 yrs
-
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
None
PERSONAL AND STATISTICAL PARTICULARS
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Henry A. Brawley
(Husband's name in full)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Carcinomatosis
2 yrs
Home)
Bye its NAME instead of street and number)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
No
(a) Residence.
No.
(Usual place of abode)
To be filed for burial permit with Board of Health or its Agent.
MR-301A 1
titions contrib -- deoth but not to the terminal condition given
( :- Chapter 137, it 1954, requires lans to print or the cause of death on certificates.
SOM-5-56-917573
Boston
Housewife
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 'or 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 imine- 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 coinmonwealth 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 dierk 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} JAT. , UlOUJ
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.
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