USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1948 > Part 1
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J. L. FAIRBANKS DIV. Thomas Groom & Co. Stationers 105 State St., Boston
To duplicate this book order No. 1625-13 O.U.7
1 If deceased was a U. S. War Veteran, G. L. Chap. 45, Section 10, requires physicians to insert a recital to that effeot. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and attvate vo carerany supplied. AVE should be stated CARVist. FhTaleTANS should state CAUSE OF DEATH in plain r
8 per mr. Buckley
6
PLACE OF DEATH
(County).
(City or Town) Winthrop Com Oda Welch
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH munity Hoop se! 8
To be filed for burial permit with Board of Health or its Agent.
1
§ (If death occurred in a hospital or institution, "{ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT (Was deceased a U. S. War Veteran, if so specify WAR)
(a) Residenca. No.
15 Otis St Winthrop St.
(Usual place of abode)
( If nonresident, give city or town and State)
Length of stay: In mocoltal or Institution.
( Before death)
( Specify whether)
Jeers
months
days.
In this community
yrs.
mos.
days
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
#FF
4 COLOR OR RACE
w
5 SINGLE
( write the word)
MARRIED
WIDOWED
or DIVORCED
Widow
5a If married, widowed, or divoroed HUSBAND of
(or) WIFE of
Master walden game of Match
( Husband's name In full)
6 Age of husband or wife if aliva
years
7 IF STILLBORN, enter that fact hera.
8 AGE 70 Years Months Days
If less than 1 day
Houre
Minutes
Usual
9 Occupation :
at home
Industry
D or Business :
-
11 Social Security No.
Braton
12 BIRTHPLACE (City)
( State or country)
maso.
13 NAME OF
FATHER
Donald Falconel
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Scotland
15 MAIDEN NAME
OF MOTHER
Mary McCormick
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Scotland
17 arthur Perrin
Informent (Address) / Warre it Melland friend
I HEREBY CERTIFY that a satisfactory standard oartifioate of death was Aled with me BEFORE the burial or transit permit was Issued : Walter &- Maker
(Signature of Agent of Board of Health or other)
1/4,48
(Official Designation)
( Date of Issue of/Permit)
18 DATE OF
DEATH
( Month)
Jan.
4
(Day)
(Year)
19 N HEREBY CERTIFY.
New. 28
19 47, to
Jam 4
1918
I last cew h.
er allva on ..
Jan 4
, 19 48, death is said to
hava occurred on the date stated above, at
1.10 P
m.
Duration
Immediate cause of death. Cerebral Nemanlage
- -
Dua to
Chronic hypertension
Due to.
Other conditions
( Include pregnancy within 3 months of death)
Major findings:
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?. Clinical Signs
IMPORTANT
Physician
Underline the cause to which death should be charged sta. tistically.
20 Was disease or injury in ony way relatad to opaupation of decaased ?.. If so, specify
... (Signed )
M. D.
(Address)
winthrop
vary
Pasta
Date Var 4 1948
Place of Burial, Cremation or Remove
(City or Town)
DATE OF BURIAL.
Lam. 8
1948
22 NAME OF
FUNERAL DIRECTOR
. Dener Buckley
.......
ADDRESS
868 Beacon St Barth
Recaived and Aled.
JAN-7 1943
19
( Registrar)
100m-(g)-1-45-15510
A R-301 A
1
No.
2 FULL NAME
(If deceesed la a married, widowed or divorced woman, give also maiden name.)
3 weeks
Registered No.
413148
1948
That I attandad daocased from
IMPORTANT Sudden 4.5 years
21
Relation, If any
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 re- quired 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, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate 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 sec- tion and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relicf 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 nine- teen 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 interment, 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 physi- cian 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 re- quired of the attending physician. If death is caused by violence, the medi- cal 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 auch 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 ieu of chapter sorry-six, tuat 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 registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary 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 only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the body lies and take charge of the same; .. . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has re- ceived 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 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 forin of injury, have died without recent medical attendance or whose phy- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably 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 .- Cause of death means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, 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 occupation had been given up or changed on account of the discase causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. 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, how- ever, 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
M R-301 A
If deceased was a U. S. War Veteran, G. L. Chap. 46, Seotlon 10, requires physicians to insert a reoltal to that effeot. extracts from the laws on back of certificate. terms, so that it may be properly classified. Exact statement of OCCUPATION is very important. See instructions and should be carefully supplied. ACE should be stated EXACTLY. PHYSICIANS should state CAUSE OF DEATH In plain
PLACE OF DEATH
Nuitholte (County)
peuttrop
....
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
2
§ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
Joseph Fautell
( If deceased is a married. widowed or divorced woman, give also maiden name.)
19 Mermaid Clic
(a) Residenca. No.
(Usual place of abode)
(If nonresident, give clty or town and State)
Length of stay: In hospital or institution.
(Before death)
( Specify whether)
years
4 hrs. 20 min.
in this community
mos.
dayı.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE|
Mtute.
5 SINGLE
( write the word)
Widowed
MARRIED
WIDOWED
18 DATE OF
DEATH
Jan
6
1148
(Month)
(Day)
(Year)
19 | HEREBY CERTIFY.
Thet I attended deceased from
alves 8, 1946.
to
Jana 6,
1948
I last saw him alive on
6
19 48, death Is said to
heve occurred on the date stated above, at.
3:20 Am.
Immediate couse of death.
Cordiali Decompemali
Decompensation
Que to Cerebral hermandage
Due to
Other conditions
(Include pregnancy within 3 mootbs of death)
Mejor findings:
Of operations
Date of.
Of autopsy
What test confirmed dlegnosis ?
IMPORTAN Physician
Underline the cause to which death should he charged sa. tistically.
20 Was diseese or injury in ony wey raleted to occupation of deceesed ?
If so, spaoity ..
M. D.
ar Caplan
(Signed)
(Address) 8G/sandlist &B.
Deto 1-6
19.4.8
21
Piace of Burial, Cremation or Removal.
OATE OF BURIAL.
Jan, 4
Vetrini
(City or Town)
2048
22 NAME OF
Benjamin Binbach
FUNERAL DIRECTOR
ADDRESS
10 lash It particles
Recalved and flad JAN 7-1949
( Registrar)
Duration 1 day IMPORTANT ....
2gps
12 BIRTHPLACE (City)
( Siale or country)
Aussice
13 NAME OF
FATHER
Mirael Fantell
14 BIRTHPLACE OF
FATHER (City)
Russia
(State or country)
15 MAIOEN NAME
OF MOTHER
Goldie Cannot be Journ
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Informan€ ( Address )
17 Solche Caplan Relation, If any (daughter
I HEREBY CERTIFY that a satisfactory standard certificats of death wes ned with me BEFORE the burial of transit damitces frais filleted Valter H. Bakery
(Signature of, Agent of Board of Health or other)
1/6/48
(Official Designation)
( Date of Issue of Permit)
100m-(g)-1-45-15510
7 IF STILLBORN, enter that fact here.
8
AGE 6
6/
Yeers
Montha
Days
If less than 1 dey
Hours
Minutes
Usual
9 Occupation :
Tailor
Industry
10 or Business :
Retired
11 Social Security No.
PARENTS
50 ff married, widowed, or divorced faller Jeder HUSBANO of
(Give maiden name of wife In full)
(or) WIFE of
( Husband's name In rull)
6 Age of husband or wife if aliva yaars
4 hrs
(City or Town) Winthrop Community Hospital No.
Registared No.
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
.
20 yrs.
months
days.
2 FULL NAME
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 re- quired 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 iu the certificate a recital to that effect, speci- fying the war, and shall also certify in such certificate both the primary and the secondary or immediate 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 sec- tion 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 nine- teen 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 exbume 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 sball bave 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 interment, 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 physi- cian 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 re- quired of the attending physician. If death is caused by violence, the medi- cal 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 bours 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, tuat 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 registration. The person to whom the permit is so given aud the physician certifying the cause of death shall thereafter furnish for registration any other neces- sary 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 only such persons as are supposed to have died by violence. If a medical examiner has notice that there is within his county the body of such a person, he shall forthwith go to the place where the hody lies and take charge of the same; . . . - General Laws, Chap. 38, Sec. 6.
No undertaker or other person shall bury a human body or the asbes thereof which have been brought into the commonwealth until he has re- ceived 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. . .. Cbap. 114, Sec. 46, G. L., (Tercentenary Edition).
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 forum of injury, have died without recent medical attendance or whose pby- sician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths sup- posably 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 .- Cause of deatb means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbid conditions, if any, related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very im- portant, 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 occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. 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, how- ever, 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
RM R-302
3 SEX
Female
9 Ocoupation :
...
Industry
10 or Business :
12 BIRTHPLACE (City)
(State or country)
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
WRITE PLAINLY, WITH UNFADING BLACK INK - THIS IS A PERMANENT RECORD
of the city or town in which the deceased resided. (See Chap. 46, Sec. 12, G. L.)
resided in another city or town at the time of death should be made forthwith and transmitted on Form R-302 to the clerk
Copies of returns of deaths recorded during the previous month which occurred in your city or town in case the deceased
(State or country)
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
5a If married, widowed, or dlvoroed
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife If allve years
7 IF STILLBORN, enter that fact here.
AGE.7.3
Years .............. Months ...
Days
If less than 1 day
Hours.
Minutes
Usual
At home
At home
11 Social Security No.
None
East Boston
Mass.
13 NAME OF
FATHER
Michael Winston
14 BIRTHPLACE OF
FATHER (City)
Ireland
15 MAIDEN NAME
OF MOTHER
Mary Mitchell
Ireland
17 James Winston
Relation, if any
Informant
(Address)
105 Sagamore Ave. Winthrop
A TRUE COPY.
Frederick H. Burke
ATTEST :
(Registrar of city or town where death occurred)
DATE FILED
January 13.
19 48
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
January
.7,
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY,
Nov. 27
That I attended deceased from
o
46
Jan. 7
19
48
I last saw her
allve on
January 7,, 19 48 death Is said to
have ooourred on the date stated above, at
6.30 A.
m.
Duration
Immediate oause of death
Generalized Arteriosclerosis
Cerebral Thrombosis
Due to
Hemplegia - right
14 mos.
Due to.
Other conditions
(Include pregnancy within 3 months of death)
Physician
Major findings :
Of operations
Date of
Underline the cause to which death should be charged sta- tistically.
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or injury in any way related to oooupation of deceased?
If so, speolfy.
William C. Moloney
(Signed)
Holy Ghost Hospital
M. D.
(Address)
Date .. 1 .... 7
19
48
21 PLACE OF BURIAL,
CREMATION OR REMOVALHoly Cross Cemetery Mald.
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