USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 57
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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 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 absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and hy the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following ahortion, 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 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 heen 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 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
...
1-301 A
PLACE OF DEATH
Suffolk
(County)
I
Winthrop
(City or Town)
No. 12 Prescott St
Thr 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 194
Registered No [ (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
William H. Fielding
(If deceased is a married, widowed or divorced woman, give also maiden name.)
I2 Prescott St
St
(If nonresident, give city or town and state)
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Vale
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Marrie
18 DATE OF
DEATH.
October
18
1940
(Month)
(Day)
(Year)
5a If married, widowed, or divorced.
HUSBAND of 1/1
M. Walsh Pricing
(Give malden name of wife in full)
(or) WIFE of.
(Husband's name in full)
50
years
6 Age of husband or wife if alive ..
7 IF STILLBORN, enter that fact here.
874
......
Years.
Months ..
.. Days
If less than 1 day
Hours .........
.Minutes
Usual
Master Printer
9 Occupation :.
Industry
10 or Business:
Printing
11 Social Security No.
12 BIRTHPLACE (City)
(State or country)
England
13 NAME OF
FATHER
Charles Fielding
PARENTS
15 MAIDEN NAME
OF MOTHER
Mary Corrigan
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
(Address).
21.
winthrop
Anthrop
Place of Burial, Cremation or Remoyal,
DATE OF BURIAL
Oct /21/1
(City of Town) 1840,
19
22 NAME OF FUNERAL DIRECTOR ADDRESS
John Maleu
Winthrop
Received and filed.
19
(Registrar)
100m-2-40-D-729-a
17
Relation, if any
Informant
Julia Fielding
(
Wife
(Address)
I2 Prescott St
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial op transit permit was issued: Wm. r Selelives.
(Signature of Agent of Board of Health or other)
HO. Oct. 19-1940 -
(Official Designation) (Date of Issue of Permit)
19 1 HEREBY CERTIFY, april 27, 1940 to October 18, 1940 I last saw him alive on October 17, 1940, death is said to have occurred on the date stated above, at. 1215 P. m.
Immediate cause of death
Duration IMPORTANT
Due to.
arteria-sclerosis
5 yrs.
Due to
Other conditions.
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings:
Of operations.
Date of ~
Of autopsy
What test confirmed diagnosis ?.
Underline the cause to which death should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of doceased ?.
If so, specify.,
Edmund Fr. moran
M. D.
(Signed)
664 Benmin
mington ST., EB Date.
OCT.18. 194
14 BIRTHPLACE OF
FATHER (City) ....
(State or country)
England
That I attended deceased from
MEDICAL CERTIFICATE OF DEATH
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
) information should be carefully sunnlied. AC.E. should ha stated EXACTLY. PHYSICIANS should is very important. See instructions and extracts from the laws on back of certificate.
...
19 39 DEC 71865 74
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death . . . Gen. Laws, Chap. 46, 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 receiv- Ing 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 licu 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 by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval 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 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 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 form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons). thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or Infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- 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 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
MR-303
WRITE DIAINTV WITH HINFARINGER of Death. See reverse side for extracts from the laws relative to the return of certificates of death. DEATH in plain terms, so that it may be properly classified under the International Classification of Causes information should be careruny supplied. MEDICAL. LAAMINEK should state CAUSE AND MANNEK Ur A
PLACE OF DEATH
F.
(County)
Botan
(City of Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS MEDICAL EXAMINER'S CERTIFICATE OF DEATH
(City or town making return)
195
Registered No.
hospital or institution, ad of street and number)
(If U. S.
War Veteran,
specify WAR)
nome
(If nonresident, give city or town and state)
days. In this community 20 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX male
4 COLOR OR RACE| 5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word) married
widowed, or divor
Helen V Collina
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.
5/
Years
7 IF STILLBORN, enter that fact here.
8 AGE 49 Years Months. Days
If less than 1 day
Hours
Minutes
Usual
9 Occupation:
Salesman
Industry
10 or Business:
Shirto
11 Social Security No ...
none
12 BIRTHPLACE (City)
Bangor
(State or country)
maine
13 NAME OF
FATHER
trank Sony
14 BIRTHPLACE OF
FATHER (City)
(State or country)
maine
15 MAIDEN NAME
OF MOTHER
Ella B (unknown)
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ariane
17 Helen VCollina
Relation, if any
Informant
(Address) 79 Cliff are, Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Childress 9 (Signature of Agent of Board of Heath or other) Health Officer 10/21/40
(Official Designatioz) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH .. October 19, 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.)
20 Accident, suicide, or homicide (specify)
Date of occurrence. 19
Where did Injury occur ?.
(City or town and State)
Did injury occur in or about home, on farm, in industrial place, in public place ? (Specify type of place)
Manner of
Injury
Nature of
Injury
While at work ?
Was there an autopsy ?.
.......
21 Was disease or injury lo any way related to occupation of deceased ?.
If so, specify.
(Signed)
M. D.
RasPacel Copeaux Date 10/14/40
22
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Oct 21
1940
23 NAME OF
FUNERAL DIRECTOR
P. C. Hvily
ADDRESS
17 Bennington as ErBoston
Received and filed 19
À TRUE COPY ATTEST:
(Registrar)
50m-10-'39. No. 8427-h
1
2 FULL NAME
Edward F. Sorry
(If deceased is a married, widowed or divorced woman, gre also maiden name.)
(a) Residence. No. 79 Cliff ave
St.
(Usual place of abode)
Length of stay : In hospital or institution
......
years
months
(Specify whether)
White
PARENTS
maldin
1
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forth with, 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 host of his knowledge and belief 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 a human hody in a town, or remove therefrom a human hody which has not heen 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 hoard, 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 tomb other than the receiving 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 buried. No such permit shall be issued until there shall have been de- livered to such board. agent or clerk, as the case may hc, a satisfac- tory written statement containing the facts required hy law to hc returned and recorded, which shall he 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 he 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 hy 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 he obtained early enough for the purpose, the certificate of death made as ahove provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal ; provided, that such hody 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 ohtained 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 he 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., as amended by Chap. 48, Acts of 1927 and Chap. 414, Acts of 1931.
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 hoard, from the clerk of the town where the hody is to be buried or the funeral is to he held, or from a person appointed to have the care of the cemetery or hurlal ground in which the interment is made .... Chap. 114, Scc. 46, G. L. as amended.
Medical examiners shall make examination upon the view of the dead bodies of only such persons as are supposed to have dicd hy 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.
... He shall in all cases certify to the town clerk or registrar in the place where the deceased dicd his name and residence, if known ; otherwise a description as full as may be, with the cause and man- ner of death .- General Laws, Chap. 38, Scc 7.
. The medical examiner certifies the cause and manner of death to the best of his knowledge and belief.
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the ohserv- ance of the following rules of practice :
(1) Allending 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 Heaith physicians will certify to such deaths only as those of persons who, though disabled hy recognized disease un- related to any form of injury, have died without recent medical attendance or whosc 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 hy traumatism (including resulting septice- mia), and hy the action of chemical (drugs or poisons). thermal, or electrical agents, and deaths following abortion, hut 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
Medical Examiners in certifying to a death will state the cause and manner thereof, and will specify: (1) Under causc, the nature of an injury and of its consequences ; and (2) under manner, the mode of its production together with the circumstances when these are known. For example: "Compound fracture of the femur with ensuing septicemia (gas bacillus) caused hy a steam railway ac- cident." "Pistol shot wound of the chest with associated hemor- rhage, homicidal." "Asphyxiation hy suspension, suicidal." "Syn- cope while under the influence of ether administered as a surgical anaesthetic." "Fracture of the skull with associated internal injury sustained under circumstances unknown."
If discase or injury was related to occupation, specify. If inves- tigation shows the death to have been due to disease, specify: (1) Under cause, its known or presumahle nature; and (2) under man- ner, indicate the circumstances leading to medico-legal inquiry. For example: "Hemorrhage spontaneous, of the hrain (basal ganglia) (found dead In bed)." "Heart disease, presumably coronary sclerosis. (Sudden death)."
DESCRIPTION (for unknown person)
NOTICE TO UNDERTAKERS: No embalming fluid, or any substitute therefor, shall be injected into the body of any person supposed to have met his death by violence, until a permit, signed by the Medical Examiner, has first been obtained .- General Laws, Chap. 38, Sec. 14.
THIS CERTIFICATE CONSTITUTES SUCH PERMIT
IRR-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No 148 Winthrop
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 196
Registered No.
§ (If death occurred in a hospital or institution, St. { give its NAME instead of street and number)
2 FULL NAME
Raymond Brewer Parker
(If deceased is a married, widowed or divorced woman, give also maiden name.)
148 Winthrop
St
(If nonresident, give city or town and state)
years
months
days.
In this community 26
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
Married
5a If married, v
Heten frances Stark
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
4.9
.. years
7 IF STILLBORN, enter that fact here.
AGE ..
8
54 Years
10 Months.
16 Days
If less than 1 day Hours. Minutes
Usual
9 Occupation:
Physician
Industry
10 or Business:
11 Social Security No.
Somerville, M
12 BIRTHPLACE (City)
(State or country)
Massachusetts
13 NAME OF
FATHER
Henry Clark Parker
PARENTS
14 BIRTHPLACE OF
FATHER (City)
Reading
(State or country)
Massachusetts
15 MAIDEN NAME
OF MOTHER
Henrietta Cogan
16 BIRTHPLACE OF
MOTHER (City) ..
Unable to obtain
(State or country)
17
Helen F. Parker
Relation, if any wife ... )
Informant (Address) 148 Winthrop St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Children 9, (Signature of Agent of Board of Health or other)
Health Officer 10/21/40
(Official Designation) (Date of Issue of/Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF DEATH. October
19 1940
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY, That I attended deceased from
July 16
, 1940, to October 19
.. ,
I last saw besor alive on October 181200, death is said to
1948
have occurred on the date stated above, at.
2.534.
.m.
Immediate cause of death .....
Coronary thembases
Duration IMPORTANT Sudden
1400
(Include pregnancy within 3 months of death)
Hypertensive
Major findings:
Of operations.
Date of.
Of autopsy
-
What test confirmed diagnosis ?.
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