USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 50
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Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis ?
20 Was disease er imjery is any way related to occupation of deceased ? If so, specify
(Signed)
G ...... Houser
M. D.
(Address)
Boston
21 PLACE OF BURIAL,
CREMATION OR REMOVAL
Winthrop
Date.
8/3719 49
Mass
DATE OF BURIAL
(Cemetery)
Sent 3 1940
19
22 NAME OF
FUNERAL DIRECTOR
H S Reynolds
ADDRESS
Winthrop Mass
Received and fled.
19
(Registrar of City or Town where deceased resided)
50m-10-'39. No. 8427-f
WWWY VI Way wygry IN wany tar utat occurred. (See Chap. 46, Sec. 12, G. L.) PARENTS
6 Age of husband or wife if alive
years
months
days.
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
(I U. S.
War Veteran,
specify WAR)
(City or Town)
Date of ..
should be charged sta- tistically.
No. Mass General Hospital
TO
SEP25 9MM
R-301 A
Suffolk (County)
Winthrop (City or Town)
'ERE NOTIFIED 19/40
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. Avi
Registered No .. (If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Josephine A. Newell
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
87 Reservoir Ave ...... Rovere.
St.
(If nonresident. give city or town and state)
months7
days.
In this community 20yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
widow
5c If married, widowed, or divorced HUSBAND of
(or) WIFE of
Henry A. Newell
(Husband's name in ful!)
6 Age of husband or wife if alive 7 IF STILLBORN, enter that fact here.
8 AGE C Years Months
Days
Hours.
Minutes
9 Occupation:
At home
11 Social Security No ... none
12 BIRTHPLACE (City)
(State or country)
N.F.
13 NAME OF
FATHER
Morris Ahearn
14 BIRTHPLACE OF
FATHER (City)
Ireland
(State or country)
15 MAIDEN NAME OF MOTHER Margaret Rowe
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
Relation, if any
daughter
(Address) 87 Reservoir Ave Revere
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed /with me BEFORE the burial or transit permit was issued: Was . Childress
(Signature of Agent of Board of Health or other)
Health Officer
9/2/40
(Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
feijão
Month)
(Day)
1940 (Year)
19 I HEREBY CERTIFY.
8/8
19.21
... ,
to ..
That I attended deceased from
9
11
19
40
I last saw be alive on
8/3/14
19
death is said
to have occurred on the date stated above, at. 5 A .m. Duration IMPORTANT
Immediate cause of death .. Central Hemplage
518 48
Hemiplegia stiridel-
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings : Of operations
Underline the cause to which death
Of autopsy
charged sta- tistically.
20 Was disease or Icjery la any way related to occupatiem of deceased?
so, specif
Franx7 Sandler
M. D.
(Address)
21
Holy Cross
Malden
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Sept.3
19.40
FUNERAL DIRECTOR
22 NAME OF
R.J. De Mille
ADDRESS
Reyere.
Received and Eled
SEP 10 1940
19
(Registrar)
are changed as peur
100m-10-139. No. 8427 Heater
1 3 SEX Usual phone calltion parce board of 9/11/40 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 10 or Business:
PLACE OF DEATII
No. Comunity .... Hospital
St. 3
.........
(Official Designation
(Signed) ..
Date
9/2
1940
.Date of ..
should be
What test confirmed diagnosis ?
...
Informant
Marggurite Murphy
years
Female White
(Give maiden name of wife in full)
years
If less than 1 day
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 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.
No nndertaker 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 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 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 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 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 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 appcar upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, sball 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 elerk 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 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 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 occupa- 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 failure, asphyxia, asthenia, etc. As principal cause name thed disease causing death. As related causes, name earlier inorbid con- ditions, 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 varlous 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 busi- 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, as housekeeper -- private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
R-305
copies of fęturns of ucatus wattu vesdresu it goes les of death should be transmitted on Form R-305 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.)
25m-10-'39. No. 8427-g
Suffolk
PLACE OF DEATH
(County) Bouton
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
BOSTON (City or town making return)
Registered No.
7671
(If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Taschula
(If deceased is a married, widowed or divorced woman, give also maiden name.)
25 Nave Way Ave
St.
Winthrop Mass
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
4 COLOR OR RACE 5 SINGLE
MARRIED
WIDOWED
(write the word)
male
white
or DIVORCED
widowed
5a If married, widowed, or divorced
HUSBAND ci
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8 69
AGE
Years.
Months.
Days
If less than 1 day
Hours
.Minutes
Usual
9 Occupation:
Industry 10 or Business:
Il Social Security No ..
12 BIRTHPLACE (City)
(State or country)
Greece
13 NAME OF
FATHER
Christos Hantaves
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Greece
15 MAIDEN NAME
OF MOTHER
16 BIRTHPLACE OF
MOTHER (City)
Greece
- (State or country)
17 Cleopatra Thera Relation, if any dau ············· )
Informant
(Address)
A TRUE COPY.
ATTEST:
von(Registral of duty or town where death occurred)
DATE FILED
9/9/40
19
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Sept 3 1940
(Month)
(Day)
(Year)
19 | 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.) fractured skull: traumatic intra- cranial hemorrhage. Multiple con- tusions & abrasions. Said to have been injured by an auto at Winthrop Sept 3-1940 Pedestrian
20 Accident, suicide, or homicide (specify)
Date of occurrence. 19.
Where did
Injury occur?
Winthrop
(City or town and State)
Did injury occur in or about the home, on farm, in industrial place, or in public place ?
Manner of
Injury
Nature of Injury
While at work ?
Was there an autopsy?
yes
21 Was disease or lajuly In any way related to occupation of deceased ?.
If so, specify
(Signed)
W. J Brickley
(Address)
Boston
Date
9/3/10
M. D.
22 Mt .... Hope
Boston
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Sept 6 1940
19
23 NAME OF
FUNERAL DIRECTOR
A C Hasiotis
ADDRESS
Boston
Recoived and filed 19
(Registrar of City or Town where deceased resided)
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
Hantaves
Mass General Hospital
No.
Mary Zanikola
years
(Specify type of place)
OCT10W43AM
----- - ----- --
1
R-305
PLACE OF DEATH -
(County) Boston
(City or Town)
No .... 818 Harrison Ave
The Commonfocalth of Massachusetts OFFICE OF THE SECRETARY COPY OF MEDICAL EXAMINER'S CERTIFICATE OF DEATH
V
(City or town making return)
Registered No ....
7666
-
(If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME
Mildred
Ward
(If deceased is a married, widowed or divorced woman, give also maiden name.)
86 Beal
Winthrop
......................
St.
months
dayı.
In this community
yrs.
mos.
days.
(Specify whether)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Sept 4 1940
(Month)
(Day)
(Year)
19 I 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,) crushed skull & fractured femur.
20 Accident, suicide, or homicide (specify).
Date of occurrence.
Sept 4 1940
19
Where did
Injury occur ?.
Paston
and State )
Did injury occur in or about the home, on farm, in industrial place, or in public place ?
Manner of
Injury
struck by automobile
Nature of injury
While at work ?
Was there an autopsy fro.
21 Was disease or injury la any way related to occupation of ćeceased ?
If so, specify
(Signed)
TimothyLeary
M. D.
(Address)
Boston
Date 9/4/40
22
Calvary.
Boston
DATE OF BURIAL
Place of Burial, Cremation or Removal.
Sept 8 9825own)
19
23 NAME OF
FUNERAL DIRECTOR
Maurice ..... Kirby
ADDRESS
Winthrop
Received and filed.
19
(Registrar of City or Town where deceased resided)
of death should be transmitted on Form R-305 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.)
25m-10-'39. No. 8427-g
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Boston Mass
(State or country)
15 MAIDEN NAME
OF MOTHER
Mildred Snow
16 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country)
Mass
17
Informant
(Address)
Relation, if any
father
A TRUE COPY.
ATTESTEA
(Registran of chtg or town where death occu
DATE FILED
19
9/9/40
-..
4 COLOR OR RACE 5 SINGLE
W
MARRIED
WIDOWED
or DIVORCED
(write the word)
single
5a If married, widowed, or divorced
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.
8 AGE 3 Years. Months Days
If less than I day
Hours
Minutes
Usual
9 Occupation:
at home
Industry 10 or Business:
II Social Security No.
12 BIRTHPLACE (City)
Boston Mass
(State or country)
13 NAME OF
FATHER
Edward Ward
(Specify type of place)
(If U. S.
War Voteran,
specify WAR)
175
(a) Residence. No ..
(Usual place of abode)
Length of stay: In hospital or institution.
(If nonresident, give city or town and state)
years
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Fem
1
suffolkx
Fan
OCT10MA M
IR-301 A
..
Suffolk 0 (County) Winthrop E NOTIFIED J/4 STANDARD (City or Town) CERTIFICATE OF DEATH Winthrop community Hospitals: { No ...
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS
To be filed for burial permit with Board of Health or its Agent a
Registered No .. (If death occurred in a hospital or institution, give its NAME instead of street and number)
(If U. S. War Veteran, specify WAR)
St.
Cash Boston
(If nonresident, give city or town and state)
Id this community
yrs.
mos.
days.
(Specify whether)
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Single
5a I/ married, widowed, or divorced HUSBAND of
(Give maiden name of wife in full)
(Husband's name in full)
Years
6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here.
If less than 1 day
AGE Years Months. Days
.Hours
Minutes
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
13 NAME OF
FATHER Joseph Fleming
14 BIRTHPLACE OF
FATHER (City) .
East Basta
(State or country) Mars
15 MAIDEN NAME
OF MOTHER
Margaret Sawyer
16 BIRTHPLACE OF MOTHER (City) (State or country)
East Boston
mass
Relation/if any
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: Wm. D. Childress (Signature of Agent of Board of health or other) Health office 9/ 9 /40 (Official Designation) (Date of Issue of Perteit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
Sent
5
1940
(Month)
(Day)
(Year)
19 N HEREBY CERTIFY. 5 197 to ....
That I attended deceased from
1920
I last saw be alive on + 5 , 19 ... death is said
2.300
m.
to have occurred on the date stated above, at ...
Immediate cause of death ...
Themati
bon
Duration IMPORTANT
5
Due to
firemat
Due to
Placent
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Planter
PHYSICIAN Underline Date of 9-5- Cloarec the cause to Grhich death should be Of autopsy charged sta- What test confirmed diagnosis ?.
20 Was disease er lajury In any way related to occupation of deceased?
If so, specify.
. M. D.
(Signed)
(Address) 6420
.19
21 Afmichaels
Đó te. Boston
Place of Burial, Cremation or Removal.
DATE OF BURIAL
19
40
9.
22 NAME OF
FUNERAL DIRECTOR
Charles 1. Treamer
ADDRESS
E. Boston
19
Received and filed SEP 10 1940
(Registrar)
1 3 SEX Male (or) WIFE of 8 Usual 9 Occupation: PARENTS 17 Informant (Address) information should be carefully supplied. AGE should be stated LAACILI . Til SiVisu Buic Industry 10 or Business: 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.
PLACE OF DEATH
2 FULL NAME
Baby Boy Flowing
(If deceased is a married, widowed or divorced woman, give also maiden name.) 39 Wordsworth
(a) Residence. No .....
(Usual place of abode)
Hospital
years
months
Length of stay: In hospital or institution ....
days.
Joseph Fleming , Faller 39 Wardswith et 6.3
(City or Town).
tistically.
19% 1542
Winthrop mass
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 deccased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and belicf the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death ... Gen. Laws. Chap. 46, Sec. 9.
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 de- livercd 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 the attending physician, if any, as required by law, or in lieu thereof a certificate as hercinafter 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 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 carly 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 transmlt 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 ohtained 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 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 septlce- 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 occupa- tion, the sudden 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, 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 complication of the principal cause.
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