Town of Winthrop : Record of Deaths 1940, Part 22

Author: Winthrop (Mass.)
Publication date: 1940
Publisher:
Number of Pages: 494


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 22


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).


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... St.


Take thatth, Cassidy Eastman


(If deceased is a married, widowed or divorged woman, give also maiden name.) 180 (Cottage Tack Rd


(a) Residence. No


(Usual place of abode)


Length of stay: In hospital or institution aapitar


years


months


V


days.


In this community /4 yrs. 4


mos. ( days.


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


April


7


(Month)


(Day)


1940.


(Year)


19 I HEREBY CERTIFY October 14. 19.2.7 .... april 7 19.


That I attended deceased from


40


I last saw het alive on. april 6, 1040, death is said


to have occurred on the date stated above, at. 1:100 m. Immediate cause of death, Cerebral Hemostige


Duration IMPORTANT 4/5/40


1939 1939 1939


PHYSICIAN Underline the cause to which death should be charged sta- tistically.


20 Was disease or injury in any way related to tccopatlod of deceased?


lf so, specify !!


J. D.


(Signed) ...


(Address) 562 Fluidey Date


21 Place of Burial, Cremation or Removal. DATE OF BURIAL Wordtum Sity Or Fax) /9/ 1940


22 NAME OF


FUNERAL DIRECTOR


ADDRESS


Received and filed 19


(Registrar)


1


(City or Town)


No ..


2 FULL NAME


(Specjis whether)


PERSONAL AND STATISTICAL PARTICULARS


3 SEX


4 COLOR OR RACE


White


termal


MARRIED


WIDOWED


or DIVORCED


(Give maiden nande of wife in full)


(or) WIFE of


6 Age of husband or wife if alive.


7 IF STILLBORN, enter that fact here.


8


92%


Years


4


AGE


Months.


29 Days


Usual


9 Occupation:


Industry


-


10 or Business:


11 Social Security No.


12 BIRTHPLACE (City)


(State or country)


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Retand


15 MAIDEN NAME


OF MOTHER


PARENTS


16 BIRTHPLACE OF


Biddeford


MOTHER (City)


(State or country)


17


M. Florence Cassidy


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION


is very important. See instructions and extracts from the laws on back of certificate.


information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


100m-10-'39. No. 8427-e


N. D .- WRITE ILATTEI, WITIT ONI AVINO WHAVE THIS TITI WU A TEAMANENI RECORD. Every item of


13 NAME OF


FATHER


Thomas Cassidy


5 SINGLE


(write the word)


Widow


5a If married, widowed, or divorced


HUSBAND of


Rw. Cyrus. Lemail. lastman


(Husband's name in full)


years


If less than 1 day


Hours.


Minutes


Pask Borth


Informant


(Address)


180 Collage Park Rd VinTherit


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Ima lechildress (Signature of Agent of Board of Health, or other)


14.8 april 8/40 (Date of Issue of Permit)


Relation, if any


Kizue . )


(Official Designation)


Due to


Arteriosclerosis


Lenilito


Due to


consective treatfacture


Other conditions zone (Include pregnancy within 3 months of death)


Major findings :


Of operations


none


Of autopsy


nor dine


What test confirmed diagnosis? Clinical x


.Date of ........


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


(If U. S. War Veteran. specify WAR)


St.


(If nonresident, give city or town and state)


PLACE OF DEATH


EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE


RETURN OF CERTIFICATES OF DEATH


A physician or registered hospital medical ofacer 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 famlly of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of hls knowledge and belief the name of the deceased, hls supposed age, the disease of which he died, defined as required by section one, where same was contraeted, the duration of his last illness, when last seen alive hy the physician or officer and the date of his death ... Gen. Laws. Chap. 46, See. 9.


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 hoard of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permlt shall be issued until there shall have heen de- livered to such board, agent or elerk, as the case may be, a satisfac- tory 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 thercof a certificate as hereinafter provided. If there is no attending physielan, or If, for sufficient reasons, his certificate cannot be obtained carly 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 selcetmen for the pur- pose. shall upon application make the certificate required of the at- tending physician. If death Is caused by violence. the medical exam- iner 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 he 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 appcar 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 and the physiclan certifying the cause of death shall thereafter fur- alsh for registration any other necessary Information which can be ohtained as to the deceased, or as to the manner or cause of the death, which the elerk or registrar may require .- Chap. 114, Sse. 45, G. L., (Tercentenary Edition.)


No undertaker or other person shall bury a human body or the ashes thereof which have been hrought into the commonwealth until he has received a permit so to do from the hoard 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 burled or the funeral Is to he held, or from a person appointed to have the care of the cemetery or burlal ground in which the Interment is made .... Chap. 114, Sec. 46, G. L., (Tarcentenary Edition)


RULES OF PRACTICE


The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :


(1) Attending physicians will certify to such deaths only as these of persons to whom they have given bedside care during a last fil- ness from disease nnrelated 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 un- related to any form of injury, have died without recent medical attendance or whose physiclan is absent from home when the certificate of death Is needed.


(3) Medieal 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 septlce- mia), and by the action of chemical (drugs or polsons), thermal, or electrical agents, and deaths following abortlon, but also deaths from disease resulting from injury or infection related to occupa- tion, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.


Statement of Canso of Death .- Cause of death means the disease, or complication which causes death, not the mode of dying, c. v., heart fallurc, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morbld con- ditions, if any, related to the principal eause and any important complication of the principal eause.


Statement of Occupation .- Precise statement of occupation is very Important, 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 deccased had retired from busl- ness, report the usual occupation prior to retirement. Children not galnfully 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, sooke-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


M R-301 A|


PLACE OF DEATH


....


Suffolk (County)


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.


Registered No .....


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


2 FULL NAME


Mary ( Sinnicks)


Jones


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


55


Washington Ave.


St.


(If nonresident, give city or town and state)


years


months


days.


In this community


9 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Widowed


(Give maiden name of wife in full)


(Husband's name in full)


years


If less than I day


Hours.


Minutes


(State or country)


Canada


(State or country)


Canada


Relation, if any


Informant


Mary R Goodwin


1.


Daughter


(Address)


I Winthrop Place Beverly


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with the BEFCHE the burial or transit permit was issued: W.m. D. Guildrelax (Signature of Agony of Board of Healey of other) Health Office 4/12/40


(Official Designation) (Date of Issue of /Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


April


10


1940


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY. That I attended deceased from


2.6


19.3.4, to Anie 10


19. Y O


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


9


1940


death is said


to have occurred on the date stated above, at. ?..


.A


.. m.


Immediate cause of death.


Duration IMPORTANT


6 years.


Due to


Due to


Other conditions


(Include pregnancy within 3 months of death)


(State or country)


Canada


13 NAME OF


FATHER


Samuel Sinnicks


Major findings :


Of operations


Of autopsy


What test confirmed diagnosis? Cheten


PHYSICIAN Underline the cause to which death should be charged sta- tistically.


20 Was disease or Injury lo any way related to occupation of deceased?


If so, specify


(Signe


(Address) Winter Man


Da Chil 11 1940


Beverly.


M. D.


21


entral Cemetery


Place of Burial, Cremation or Rethoyal.


(City or Town)


19.40


DATE OF BURIAL.


April


I3


22 NAME OF


Howard S Punoles


FUNERAL DIRECTOR


ADDRESS


Winthrop meus.


Received and filed.


19 ......


(Registrar)


(If U. S. War Veteran, specify WAR)


(a) Residence. No ..


(Usual place of abode)


Length of stay: In hospital or institution ...


(Specify whether)


1


Winthrop


(City or Town)


3 SEX


4 COLOR OR RACE


Female


White


5c: If married, widowed, or divorced


HUSBAND of


(or) WIFE of


William K Jones


6 Age of husband or wife if alive


7 IF STILLBORN, enter that fact here.


8


AGE .86


Yours .. 5.


Months27


Days


Usual


9 Occupation:


Housewife


Industry


10 or Business:


Own Home


II Social Security No.


12 BIRTHPLACE (City)


Labrador


14 BIRTHPLACE OF


FATHER (City)


Labrador


PARENTS


16 BIRTHPLACE OF


MOTHER (City)


Labrador


17


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION


is very important. Sec instructions and extracts from the laws on back of certificate.


information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


100m-10-'39. No. 8427-e


N. D .- WRTIL PLAINLY, WEIT UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of


15 MAIDEN NAME


OF MOTHER


Almira Keats


No. 55 Washington Ave.


St. ¿


Date of.


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 regis- tration 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 eontracted, 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.


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 sueh board, from the elerk 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 elerk of the town where the body is buried. No such permit shall be issued until there shall have been de- livered to such board, agent or clerk, as the case may be, a satisfac- tory written statement containing the faets required by law to be returned and recorded, which shall be accompanied, in ease 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 physician who is a member of the board of health, or employed by it or by the seleetmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused by violenee, the medical exam- iner shall make sueh 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 shali 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 registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish 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.)


No undertaker or other person 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 observ- ance 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 ill- ness 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 un- related to any form of injury, have died without recent medical attendanee 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 septice- mia), 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 relaled to occupa- tion, the sadden deaths of persons not disabied 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, ete. As prineipal cause name the disease causing death. As related eauses, name earlier morbid con- ditions, if any, related to the principal cause and any important complieation of the principal eause.


Statement of Occupation .- Precise statement of occupation is very important, so that the relative healthfulness of various pursuits can be known. Make some entry in this seetion 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 busi- nesa, report the usual oceupation 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, however, designate the occupation 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


R-301 A


PLACE OF DEATH


Suffol (County)


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.


Registered No (If death occurred in a hospital or institution, give its NAME instead of street and number)


2 FULL NAME


Frank Allen Thomas


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


80 Hermon St


........................... St.


months


days.


In this community 40


yrs.


mos.


days.


(Specify whether)


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE


MARRIED


WIDOWED


or DIVORCEDMarried


5a If married, widowed, or divorced


HUSBAND of


(Give maiden name of wife in full)


(Husband's name in full)


Years


If less than 1 day


Hours.


Minutes


(State or country) canada


100m-10-'39. No. 8427-e


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of/tra; sit permit was issued: Wm. D. Children (Signature of Agent of Board of Health of other) Health Offices 4/11/40


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH


4


Month)


10


(Day)


(Year)


19 | HEREBY CERTIFY.


41.


19.3 ... , to


That I attended deceased from


19.4-0.


...


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


110


194.


death is said


to have occurred on the date stated above, at ..


........... m.


Duration


IMPORTANT


Immediate cause of death.


7 ....


Stomach


1gr


Due to


Due to


Other conditions Gen. Culino Selever (Include pregnancy within 3 months of death)


Major findings :


Of operations


Date of ..


Of autopsy


What test confirmed diagnosis ?.


PHYSICIAN Underline the cause to which death should be charged sta- tistically.


20 Was disoase or Injury in any way related to occupation of deceased?


If so, specify


(Signed)


Hume


/. .. M. D.


(Address) Vrathing


21 Winthrop Place of Burial, Cremation or Removal. DATE OF BURIAL


Winthrop


22 NAME OF


FUNERAL DIRECTOR


ADDRESS


for !! finOmaley


Winthrop


.........


Received and filed.


19


(Registrar)


....


Date 4/19 940


Relation, if any Son


Wirwur


St. {


(If U. S. War Vetoran, specify WAR)


(If nonresident, give city or town and state)


years


Winthrop


(City or Town)


No. 86 Hormon St


(a) Residence. No ..


(Usual place of abode)


Length of stay: In hospital or institution.


3 SEX


4 COLOR OR RACE


Male


Thite


(or) WIFE of


57


6 Age of husband or wife if alive.


7 IF STILLBORN, enter that fact here.


8


AGE 7.O.


Years


Months


Days


10 or Business:


Electrical!


1I Social Security No.


12 BIRTHPLACE (City)


Montreal


13 NAME OF


FATHER


PhillipThomas


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Canada


15 MAIDEN NAME


OF MOTHER


Elizabeth Holly


16 BIRTHPLACE OF


PARENTS


MOTHER (City)


(State or country)


Canada


17


Informant


John Thomas


(Address)


86 Hermon St


information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state


Usual


9 Occupation:


Electrforan


is very important. See instructions and extracts from the laws on back of certificate.


CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION


Industry


(write the word)


40


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 regis- tration a standard certificate of dcatb, 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 scen alive by the physician or officer and the date of his death ... Gen. Laws, Chap. 46, Sec. 9.


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 cxbume 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 de- livered to such board, agent or clerk, as the case may be, a satisfac- tory 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 tbe 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 cnough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the sclectmen for the pur- pose, shall upon application make the certificate required of the at- -tending physician. If death is caused by violence, the medical exam- iner 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 inake 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 registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish for registration any other necessary information which can be obtaincd 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.)




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