Town of Winthrop : Record of Deaths 1940, Part 29

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


USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 29


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).


Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36 | Part 37 | Part 38 | Part 39 | Part 40 | Part 41 | Part 42 | Part 43 | Part 44 | Part 45 | Part 46 | Part 47 | Part 48 | Part 49 | Part 50 | Part 51 | Part 52 | Part 53 | Part 54 | Part 55 | Part 56 | Part 57 | Part 58 | Part 59 | Part 60 | Part 61 | Part 62 | Part 63 | Part 64 | Part 65 | Part 66 | Part 67 | Part 68 | Part 69 | Part 70


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 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).


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 hedside 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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia). and hy 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 hy recognized dlsease, 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 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 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, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION.


M R-301 A1


Suffolk


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


Alfred Ernest Smith


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


57 Birch Road


.......


SE.


(If nonresident, give city or town and state)


months


days.


In this community22 yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


5 SINGLE


MARRIED


WIDOWED


or DIVORCED


(write the word)


Married


Sa If married, widowedpor giroused Viola Urquhart HUSBAND of


(Give maiden name of wife in full)


(Husband's name in full)


49


.years,


If less than 1 day


Hours


Minutes


9 Occupation:


Combustion Engineer


11 Social Security No.


010-09-9154


Gust on


(State or country) Mead County, Kentucky


13 NAME OF


FATHER


George W. Smith


FATHER (City)


(State or country)


Mead County Kentucky


15 MAIDEN NAME


OF MOTHER


Unable to obtain


16 BIRTHPLACE OF Unable to obtain MOTHER (City) (State or country)


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


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Now.8 . Chil dress (Signature of Agent of Board of Health & other)


Health Officer


(Official Designation)


(Date of Issue of/Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


May


14


1948


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY


12


19.3.2 .. , to ....


May 14


19 40


Vlast Saw h ...... alive on Man 14


19 40, death is said


to have occurred on the date stated above, at 5 A


...... m.


Duration


IMPORTANT


Immediate cause of death ... ANGI


Due to Con Cedo


Due to


Other conditions


(Include pregnancy within 3 months of death)


Major findings :


Of operations


Date of.


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


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


If so, specify,


(Signed) Hay ward


(Address) Written Man


, M. D.


Date 5/14


19 .. X.


21 Oak Grove Cemetery


Medford Mass


Place of Burial, Crematiop or Removal.


DATE OF BURIAL


194'e or Town)


19


22 NAME OF


FUNERAL DIRECTOR


Charles R. Bennison


ADDRESS


winthrop Mass


Received and filed 19


(Registrar)


(County)


1


inthron


(City or Town)


(a) Residence. No ..


(Usual place of abode)


Length of stay : In hospital or institution ..


3 SEX


Male


4 COLOR OR RACE


White


(or) WIFE of


6 Age of husband or wife if alive


7 IF STILLBORN, enter that fact here.


8


AGE


58


Years


11


Months


8


Days


Usual


10 or Business:


12 BIRTHPLACE (City}


14 BIRTHPLACE OF


Guston


PARENTS


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


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


Construction: '


PLACE OF DEATH


No 57 Birch Road


........


Relation, if any


17 Informant Florence V. U. Smith .wife ..... )


(Ad 5% Birch Rd. Winthrop Mass


5/14/40


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


years


(Specify whether)


That I attended deceased from


4 year


Of autopsy


What test confirmed diagnosis Lehumation


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 anthorlzed 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 bellef the name of the deceased, his supposed age, the disease of which he dicd, defined as required by section one, where same was contracted, 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, Sec. 9.


No undertaker or other person shall bury or otherwise dispose of & human body in a town, or remove therefrom a human hody which has not been huried, 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 hody and remove it from a town, from one cemetery to another, or from one . grave or tomh 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 hody is buried. No such permit shall be issued until there shall have been dc- livered to such hoard, agent or clerk, as the case may be, a satisfac- tory written statement containing the facts required by law to he returned and recorded, which shall be accompanled, in case of an original interment, by a satisfactory certificate of the attending physiclan, if any, as required hy 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 carly enough for the purpose, or is Insufficient, a physician who is a member of the hoard of health, or employed hy it or by the selectmen for the pur- pose, shall upon application make the certificate required of the at- tending physician. If death is caused hy 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 ohtalncd 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 shail 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 hy 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 heen 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 ax to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, See. 43, G. L., (Tercentenary Edition.)


No undertaker or other person shall bury a human body or the ashes thereof which have heen hrought Into the cominonwealth 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 hody Is to he huried or the funeral is to be held, or from a person appointed to have the care of the cenietery 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 these 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 disahled by recognized disease un- related to any forni of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.


(8) Medical Examiners will investigate and certify to all deaths supposably duo 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 related to ocrupa. tion, 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 fallure, asphyxia, asthenia, etc. As principal cause name the . disease causing death. As related causes, name earlier morbid con- ditions, if any, related to the principal cause and any important complleation of the principal cause.


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 deceased had retired from busl- ness, 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, however, designate the occupation by the appropriate terms, 88 housekeeper -- private family, cook-hotel, etc. For a person who had no occupation whatever write none.


SPACE FOR ADDITIONAL INFORMATION


R-302


2 FULL NAME


3 SEX


4 COLOR OR RACE 5 SINGLE


MARRIED


WIDOWED


or DIVORCED


female


white


----


5a If married, widowed, or divorced


HUSBAND of


(or) WIFE of


6 Age of husband or wife if alive.


7 IF STILLBORN, enter that fact here.


8


AGE.45


Years


Months.


Days


Usual


at home


9 Occupation:


Industry


10 or Business:


II Social Security No ..


14 BIRTHPLACE OF


FATHER (City)


15 MAIDEN NAME


OF MOTHER


Mary E Quinn


PARENTS


16 BIRTHPLACE OF


MOTHER (City)


(State or country)


17


Informant.


(Address)


above


50m-10-'39. No. 8427-f


of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible


after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)


Copies of returns of deaths Which occurred in your city or town in case the deceased resided in another city or town at the time


(State or country)


Boston Mass


(write the word)


single


(Give maiden name of wife in full)


(Husband's name in full)


.. Years


If less than I day


Hours.


Minutes


12 BIRTHPLACE (City)


(State or country)


Boston Mass


13 NAME OF


FATHER


James S McFague


Relation, if any


Arthur L McFague ( bro ..


A TRUE COPY.


ATTEST:


O Branche


(Registrar of city or towp where death occurred) 5/20/40


DATE FILED 19


MEDICAL CERTIFICATE OF DEATH


18 DATE OF


DEATH.


May16 1940


(Month)


(Day)


(Year)


19 | HEREBY CERTIFY. . That I attended, deceased from


4/27/40


19.


to ...


5/16/40


19.


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


5/16/40


19.


..... death is said


to have occurred on the date stated above, at. 1.56P m.


Duration


Immediate cause of death. congestive ... heart ... failure


2


mos


Due to .. rheumatic ... heart ... disease


10 yrs


Due to


Other conditions cardiac cirrhosis of liver unk (Include pregnancy within 3 months of death)


PHYSICIAN


Major findings :


Of operations


Underline the cause to


Of autopsy


What test confirmed diagnosis ?..... autopsy


which death should be charged sta- tistically.


20 Was disease or Injury le any way related to occupatloo of deceased ?


If so, specify


(Signed)


W .... B. Osgood


M. D.


(Address)


P ... B.B .... Hosp


Date.


5/16/1940


21 PLACE OF BURIAL.


CREMATION OR REMOVAL ......


Winthrop


Mass


(Cemetery)


(City or Town)


DATE OF BURIAL


May .... 20 ..... 1940


19


22 NAME OF


FUNERAL DIRECTOR


W ..... J .... Cassidy


ADDRESS


Boston


Received and filed


J


19


(Registrar of City or Town where deceased resided)


1


PLACE OF DEATH


1 SUFFOLK


(County) DOSTON


(City or Town)


The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH


BOSTON


(City or town making return)


Registered No ..


459.9.


(If death occurred in a hospital or institution,


St. give its NAME instead of street and number)


·MoFaguo


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


95


(a) Residence. No ....


(Usual place of abode)


Length of stay : In hospital or institution.


(Specify whether)


39 ... Fairview


St.


Winthrop Mass


(If nonresident, give city or town and state)


years


months


days.


In this community


yrs.


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


Peter Bent Brigham Hosp


No ......


Kathloon ... A


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


Boston Mass


Date of.


TOWN


مل


C:


6


HROP


JUN-71940


I R-301 A


PLACE OF DEATH


Suffolk (County)


Tint' roo


(City or Town)


No 34 Fremont St


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


Simson Joseph


Rock


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


34 Fremont St


St


(If nonresident, give city or town and state)


40


mos.


days.


PERSONAL AND STATISTICAL PARTICULARS


4 COLOR OR RACE


White


5 SINGLE


(write the word)


MARRIED


WIDOWED


or DIVORCED Vidowed


5a If married, widowed, or divorced


Mary A Mccarthy


HUSBAND of.


(Give maiden name of wife in full)


(or) WIFE of


(Husband's name in full)


6 Age of husband or wife if alive.


years


7 IF STILLBORN, enter that fact here.


If less than 1 day


AGE


Years.


Months ..


Days


Hours.


.Minutes


9 Occupation :


Retired


10 or Business:


Town Employee


11 Social Security No ...


12 BIRTHPLACE (City)


(State or country)


Mass


13 NAME OF


FATHER


Joseph Rock


14 BIRTHPLACE OF


FATHER (City)


(State or country)


Vermont


15 MAIDEN NAME


OF MOTHER


Mary Cyr


16 BIRTHPLACE OF MOTHER (City) (State or country) Canada.


Relation, if any


mery Rock ( Daughter 21. Winthrop Winthrop


Informant.


(Address)


34 Fremont St.


I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Jau. D. Children (Signature of Agent of Board of Health orother) Match Officer 5/20/40


(Official Designation) (Date of Issue of Permit)


MEDICAL CERTIFICATE OF DEATH


18 DATE OF DEATH. may


18


1940


(Month)


(Day)


(Year)


19 I HEREBY CERTIFY, That I attended deceased from n nhar, 1938, to may 18 19 40


I last saw him alive on may 18 19 40, death is said to have occurred on the date stated above, at .... 10 3 P.m.


Immediate cause of death apparently


Duration IMPORTANT


aranan occlusion


Due to


Due to.


Other conditions.


Diabetes mellitus


(Include pregnancy within 3 months of death) Recent computational chiale


3. sylar IMPORTANT


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


20 Was disease of injury in any way related to occupation of deceased? no


If so. specify


M. D.


(Signed)


(Address) 287 Shirley DX


Date 5-19


19:40


Place of Burial, Cremation or Removal. (City or Town)


DATE OF BURIAL. Mey/ 220 1948 19


22 NAME OF FUNERAL DIRECTORA, ADDRESS


John J. OMalen


Received and filed


19


(Registrar)


100m-2-'40-D-729-a


1


3 SEX


Male


8


68


Usual


PARENTS


17


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


AGE should be stated EXACTLY. PHYSICIANS should state


information should be carefully supplied.


Major findings: Of operations.


Date of.


Of autopsy


What test confirmed diagnosis? Bloods maluca


Cambridge


St.


(If U. S.


War Veteran.


specify WAR)


(a) Residence. No ..


(Usual place of abode)


Length of stay: In hospital or institution.


(Specify whether)


years


months


days.


In this community


yrs.


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 hest of his knowledge and belief the name of the deceased. his supposed age, the disease of which he died. defined as required hy section one, where same was contracted, 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, Sec. 9.


No undertaker or other person shall bury or otherwise dispose of a human hody 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 hoard, 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 tomh other than the receiv- ing tomh 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 huried. No such permit shall he 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 hy law to he returned and recorded, which shall be accompanied, in case of an original interment, hy 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 in- sufficient, a physician who is a member of the board of health, or em- ployed by it or hy 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 hody, 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 re- moval of such body has heen 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 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).


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 hoard of health or its agent appointed to issue such permits, or if there is no such hoard, from the clerk of the town where the body is to he huried or the funeral is to be held, or from a person appointed to have the care of the cemetery or hurial 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 hy recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is ahsent from home when the certificate of death is needed.


(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly hy traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, hut also deaths from disease resulting from injury or Infectlon related to occupation, the sudden deaths of persons not disabled hy recognized dlsease, 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 morhid 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 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 deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may he 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 hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.




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