USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1960 > Part 9
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TICTIONS OR L'ERTIFICATE a lving F DEATH 1; enter e lan one se or each ) and (c)
i's not mean d of dying, rart failure. . It means or compli- ich caused
if any, the rise to (a), be under- last.
Tuse
duas contrib -- ith but not to he terminal co ition given
hapter 137, 4, requires insto print or the cause or o' death ordcates.
50M-1-58-921876
Winthrop (City or Town)
Winthrop Come lescent Homme SOPHIE FITZ PATRICK
2 FULL NAMEIT
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence.
No.
103 Endicott Ave
-St.
Revere
(If nonresident, give city or town and State)
INTERVAL
BETWEEN
ONSET ANO
DEATH
10/24
PARENTS
M. D.
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. See. 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 elerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, Sec. 6 , as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deathsonly as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the oceupation by the appropriate terms, as housekeeper-private family, cook-hotel, ete. 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
FEB 1 51960 1 .:
-
If deceased was a U. S. War Veteran, G.L. Chap. 46, Section 10, requires physicians to insert a recital to that effect.
1
SUFFOLK
(County) WINTHROP (City or Town) 267 Washington Avenue, Winthrop
The Commonwealth of Massachusetts JOSEPH D. WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
36
(If death occurred in a hospital or institution, St. ¿ give its NAME instead of street and number) No.
2 FULL NAME LYMAN R. MCKAY (changed by Co.)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
(if so specify WAR)
(a) Residence. No.
267 was ington Avenue, Winthrop
St
(Usual place of abode)
25
Length of stay : In place of death.
years.
months ...
......... days. In place of residence
50
.years .............. months .............. days.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
9 SEX
10 COLOR
(write the word)
DEATH
(Month)
(Day)
(Year)
4I HEREBY CERTIFY that I have investigated the death of the person above named and that the CAUSE AND MANNER thereof are as follows: (If an injury was involved, state fully.) Parkinsonism
11a ff married, widowed, or divorced
HUSBAND of
Ida Grover
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
5 Accident, suicide, or homicide (specify)
Accident
Date and hour of injury
2/12
60
IF ACCIDENTAL, was injury causally related to the death?
Where did
Injury occur ?
Winthrop
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, or in
public place ?
home
Manner of
Accidental #811'to floor
Injury
(How did injury occur ?)
Nature of
Injury
While at work ?
.Was autopsy performed ?
No
6 Was disease or injury in any way related to occupation of deceased?
If so, spesif.
Munhall Longo
M. D.
(Signed)
Michael A. Luongo, M.D.
Boston
(Print or Type Signature)
2/15/60
19.
(Address)
Date
7
winthrop
Winthrop
Place of Burial, or Cremation.
(City or Town)
DATE OF BURIAL
Feb.
13
19.
60
8 NAME OF
FUNERAL DIRECTOR
Foward
He nolds
ADDRESS
inthror
Mass
Received and filed
FEB 16 1960
19.
PARENTS
18 NAME OF
FATHER John
Boulder
19 BIRTHPLACE OF
FATHER (City)
Lawrence
(State or country)
Lass.
20 MAIDEN NAME
OF MOTHER
Hennette Lickay
21 BIRTHPLACE OF
MOTHER (City)
(State or country)
England
Ida G ... chay
22
Informant
(Address)
267 ashin ton ive inthron
I HEREBY CERTIFY that a satisfactory standard certificate of death
was filled with me BEFORE the burial or transit permit was issued:
Ralph @ Sercanning
(Signature of Agent of Board of Health of omer)
Create Officer
2/16/60
(Official Designation)
(Date of Issue of Perinit) Y
VACA INA-IIIIS IS A FERMANENI KELUKU. Every Item ot
information should be carefully supplied. MEDICAL EXAMINERS should state CAUSE AND MANNER OF
DEATH in plain terms, so that it may be properly classified under the International Classification of Causes
§§ 44-48.
35M-11-59-926662
PLACE OF DEATH
M R-303 A 1
1-6-180
of Death. See reverse side for additional information. See also Chap. 38, §§ 6, 20; Chap. 46, §§ 9, 10; Chap. 114,
12 IF STILLBORN, enter that fact here.
13
59
AGE
Years ..
11 Months 10 Day:
If under 24 hours
Hours
....
. Minutes
14 Usual
Engineer
Occupation :
(Kind of work done during most of working life)
15 Industry
Durine
or Business :
16 Social Security No. 015-1-479
17 BIRTHPLACE (City)
(State or country)
Tass.
Malden
11 SINGLE
MARRIED
WIDOWED
or DIVORCED Carried
Lale
white
(If nonresident, give city or town and State)
3 DATE OF
February
15,
1960
Cerebral contusion
19
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 following 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 poison) 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under cause the nature of an injury and of its consequences; and (2) under manner the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused by a collision of railroad train and automobile." "Pistol shot wound of the chest with associated hemorrhage, homicidal." "Asphyxiation by suspension, suicidal." "Syncope while under the influence of ether administered as a surgical anaesthetic for (enter name of operation and disease or condition requiring surgery) ." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If disease or injury was related to occupation, specify. If investigation shows the death to have been due to disease, specify: (1) Under cause its known or presumable nature; and (2) under manner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous of the brain (basal ganglia) (found dead in bed)." "Heart disease, presumably coronary sclerosis. (Sudden death.)"
X PLACE OF DEATH
Suffolk. (County)
CONSER
Winthrop (City or Town)
The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No.
37
St. ¿ give its NAME instead of street and number) No. Winthrop Community Hospital
2 FULL NAME
Keough, Henry E.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 78 Waldemar ... Ave. St.
(Usual place of abode)
(If nonresident, give city or town and State)
.years. months .. .. ... davs.
MEDICAL CERTIFICATE OF DEATH
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
MARRIED
WIDOWED
or DIVORCED
Grried
4 I HEREBY CERTIFY, That I attended deceased from
....
Jan 22, 1960, to Feb 19, 1960
19
I last saw himalive on
feb 19 1960
death is said to
have occurred on the date stated above, at
2:00 AM
INTERVAL BETWEEN ONSET AND
DEATH
12
72
10
26
If under 24 hours
Hours.
.. Minutes
Due To (b) .... Coronary Artery ..... heart
disease
Due To (c)
OTHER
SIGNIFICANT
CONDITIONS
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)
Charles Libriman
M. D.
Charles Liberman (PRINT OR TYPE SIGNATURE)
(Address)
Winthrop
Date ....
2/19/60
6 inthron
inthron
Place of Burial or Cremation
(City or Town)
DATE OF BURIAL
Feb. ?!
19.50
7 NAME OF
FUNERAL DIRECTOR
Howard & Reynolds
ADDRESS
inthrop
Vass.
Received and filed FEB 23 1960
19
(Registrar)
PARENTS
21 Grace E Aeouch
Informant
(Address)
13 Waldemar ive. inthron
I HEREBY CERTIFY that a satisfactory standard certificate of death was Aled with me BEFORE the burial or transit permit was issued:
(Signature of Agent of Board of Health of other) Health Officer 2/23/60
(Official Designation)
(Date of Issue of Permit)
STRUCTIONS FOR AL CERTIFICATE
n giving E OF DEATH
not enter re than one se for each , (b) and (c)
does not meon ode of dying, s heart foilure. , etc. It meons ease, or compli- which coused
itions, if ony, I gave rise to couse (0), the under- couse lost.
nditions contrib- o deoth but not to the terminol condition given
:- Chapter 137, f 1954. requires ians to print or the cause or of death on certificates, and er 48, Acts of requires Physi- to print or type ander signature.
MIS.
M-6-59-925686
3yrs,
13 Usual
Occupation :
Contractor
(Kind of work done during most of working life)
14 Industry
Plumbing and Reatin
or Business :
15 Social Security No. 023-09-9918
Chelsea
16 BIRTHPLACE (City)
(State or country)
Lass.
17 NAME OF
FATHER
Henry E Keough
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Unable to obtain
19 MAIDEN NAME
OF MOTHER Charlotte Nogers
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Boston
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Coromary Occlusion
4 WKS AGE.
Years
Months.
Days
10 SINGLE
(write the word)
3 DATE OF
DEATH
(Year)
3.960
S(If death occurred in a hospital or institution,
PHYSICIAN - IMPORTANT [(Was deceased a { U. S. War Veteran, lif so specify WAR)
Length of stay: In place of death. ...... . .. years. . months 2 8days. In place of residence. 50
10a If married, widowed, or divorced E Perkins
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
UL
To be filed for burial permit with Board of Health or its Agent.
M R-301A 1
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 following 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 un- related 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 occu - pation, 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 impor- tant, 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 bad 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. Chil- dren 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.
FEB 2 31960 TH
PLACE OF DEATH
Suffolk (County)
M R-301A 1 Winthrop (City or Town)
No.
$21 Shirley St
The Commonwealth of Massachusetts JOSEPH D WARD SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
Registered No. 38
[(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)
2 FULL NAME
Charles A Lindberg
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
921
Shirley St.
( Usual place of abode)
12
12
(If nonresident, give city or town and State)
Length of stay : In place of death. ... years. months. .. days. In place of residence .years. months .. days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
(Month)
(Day)
2/
1960
(Year)
8 SEX
Male
9 COLOR
White
10 SINGLE
MARRIED
WIDOWED
or DIVORCEDdoMes
4 I
HEREBY
CERTIFY
May
I last saw h./ Malive on
Feb 18
19600
death is said to
have occurred on the date stated above, at
6.05P
.. m.
INTERVAL BETWEEN ONSET AND DEATH
11 IF STILLBORN, enter that fact here.
12
90
AGE
Years.
7
Months.
8
Days
If under 24 hours
Hours ........... .Minutes
13 Usual
Occupation :
Contractor
(Kind of work done during most of working life)
14 Industry
or Business :
Painting
15 Social Security No.
None
16 BIRTHPLACE (City)
(State or country)
Sweden
Lindberg
17 NAME OF
FATHER
Unable to obtain
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Sweeden
19 MAIDEN NAME
OF MOTHER
Unable to obtain
20 BIRTHPLACE OF MOTHER (City) (State or country) Steeden
21 Mabel Caldwell
Informant
(Address)
92I
Shirley St. inthron
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
7 NAME OF
FUNERAL DIRECTOR
Howard & Reynolds
ADDRESS int rop Mass
Received and filed February 24, 1960
PARENTS
(Signed) Deple Gregone M. D.
MuKasey 45 are (PRINT OR TYPE SIGNAT
(Address)
Date. 2 .29 60
6 Winthrop
winthrop
Place of Burial or Cremation
DATE OF BURIAL
(City or Town)
19. Feb. 25 60
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
10a If married, widowed, or divorced ina Anderson
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
Myocardial Heart
(a)
Disease
Due To
arteriosclerosis
(b)
gen -
Due To
Semility
(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 sof specify
tions, if any, gave rise to cause (a), g the under- cause last.
iditions contrib- › death but not to the terminal condition given
:- Chapter 137, 1954. requires sans to print or :he cause or death l'ertificates, and Fr 48, Acts of Requires Physi- to print or type ·nder signature.
. 5.in
01-6-59-925686
(Official Designation)
(Date of Issue of Permit)
(Signature of, Agent of Board of Health gr other)
Tealle Chicer 2/24/60
To be filed for burial permit with Board of Health or its Agent.
TRUCTIONS FOR IL CERTIFICATE
n giving E OF DEATH not enter re than one se for each , (b) and (c)
does not mean ode of dying, heart failure, , etc. It means ase, or compli- which caused
to ........
Feb 21
That I attended deceased from
,60
St.
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 following Files 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 un- related 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 occu- pation, 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 impor - tant, 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. Chil- dren 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.
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