USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 62
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589 Bea
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. . . . Chup. 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., lieart 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-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No. 80 Read
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, 210
Registered No .. § (If death occurred in a hospital or institution, { give its NAME instead of street and number) -
2 FULL NAME
Cassie Jane Victoria (Morrow) Moore
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
80 Read
St
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
(If nonresident, give city or town and state)
In this community 55
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widowed
(Month)
(Day)
(Year)
Sa lf married, widowed, or divorced
HUSBAND of.
(Give maiden name of wife in full)
(or) WIFE of
Eli Moore
(Husband's name in full)
6 Age of husband or wife if alive
.years
7 IF STILLBORN, enter that fact here.
Years 9 Months. 15
Days
lf less than 1 day Hours Minutes
9 Occupation :.
At home
10 or Business:
11 Social Security No.
12 BIRTHPLACE (City).Prince Edward Island (State or country)
13 NAME OF FATHER Lemuel Morrow
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Prince Edward Island
15 MAIDEN NAME OF MOTHER Ermina
( Unable to obtain maiden name)
16 BIRTHPLACE OF MOTHER (City) (State or country) Unable to obtain
Relation, if any
(Address) 80 Read St Winthrop Mass
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Man.D. Children x (Signature of Agent of Board of Health or offer Health Officer 11/18/40
(Official Designation) (Date of Issue of Permit)
I HEREBY CERTLEY. That I attended, deceased from
may 27
1936 to november 16 1940 I last saw her alive on. november 15 1940 death is said to have occurred on the date stated above, at. 10 p. m.
Immediate cause of death .... acute Coronary Thrombosis /2 hours
Due to
arquia Pectoris
/ year
Due to
arteriosclerosis
4 years 0
Other conditions ..
none
(Include pregnancy within 3 months of death)
IMPORTANT
PHYSICIAN
Major findings:
Of operations.
none
Of autopsy ..
not done
...... Date of.
What test confirmed diagnosis? Clinicaly latinatory
20 Was disease or injury in any way related to occupation of deceased? 100
If so, specify ....
abrams M. U.
A
(Signed)
1362 Shirley Date 1/18
19 40
21 Winthrop Cemetery winthrop
Place of Burial, Cremation or Removal.
DATE OF BURIAL. November 19
(City_or Town)
1940
19
22 NAME OF FUNERAL DIRECTOR. Charles R. Bennison
ADDRESS
Winthrop Mass
Received and filed 19
(Registrar)
1 8 78 AGE Usual PARENTS 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 N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. EVery item of Industry 100m-2-'40-D-729-8
St.
(lf U. S.
War Veteran,
specify WAR)
1940
18 DATE OF
DEATH.
november 16
Duration IMPORTANT
Underline the cause to which death should be charged sta- tistically.
17 Flossie W. Moore daughter
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 inember of the family of the deceased, furnish for registration a standard certificate of death, stating to the hest of his knowledge and helief the name of the deceased, his supposed age. the disease of which he died, definded as required hy section one, where saine 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 been huried, until he has received a perinit 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 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 toinh 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 hody 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 he 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 he obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the hoard of health, or em- ployed by it or by the selectmen for the purpose, shall upon application inake the certificate required of the attending physician. If death is caused hy violence, the medical examiner shall make such certificate. If such a permit for the removal of a hunan hody, 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 shali 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 been sooner ohtained 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 hoard 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 hoard, from the clerk of the town where the hody is to be huried or the funeral is to he lield, 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 Heaith 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 supposahiy 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 ahortion, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disahied hy 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 principai 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 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 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.
SPACE FOR ADDITIONAL INFORMATION
AR-301 AJ - Suffolk (County)
1
Vinthrob
(City or Town)
No .. Winthrop Community
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD
To be filed for burial permit with Board of Health or its Agent. 211
Registered No
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
2 FULL NAME Katherine
Hard.
Scoville
(If deceased is a married, widowed or divorced woman, give also maiden name.)
87 Shore Drive
.St.
(If nonresident, give city or town and state)
Length of stay: In hospital or institution,
(Specify whether)
years
months
6
days.
In this community 20 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
3 SEX
4 COLOR OR RACE
White
5 SINGLE
(write the word)
18 DATE OF
DEATH
november
19
1940
(Month)
(Day)
(Year)
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
(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
Hours.
Minutes,
Usual
9 Occupation:
Teacher
Industry
10 or Business:
Vinthron Schools
Due
Other conditions General peritonitis
24hrs
12 BIRTHPLACE (City)
Middleton
(State or country)
Conn.
PHYSICIAN
Major findings :
Carcinoma of Sigmoid
Of operations
General peritonitis ate of Nov 15/40
Of autopsy
nous
should be
charged sta- tistically.
28 Was disease or lajury in any way related to occupation of deceased? laboratory no
If so, specify ..
Jacobo abrams M. D.
., M. D.
(State or country)
Conn
17
Relation, if any
Sister .... )
Informant.
Mary Scoville
(Address)
Meridan Conn
21 St. Johns
Place of Burial, Cremation er Removal,
"fityzpoTown)
DATE OF BURIAL
19
Middleton Conn.
22 NAME OF
FUNERAL DIRECTOR
ADDRESS
Winthrop
Received and filed led/
19
(Registrar)
DVAATIV
informsFor DEATH in piain terms, so that it may be properly classihed. Exact statement of OCCUPATION AND L.JIJ L
is very important. See instructions and extracts from the laws on back of certificate.
100m-10-'39. No. 8427-e
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Www. D. Children (Signature of Agent of Board of Health or other)
Health Officer
(Official Designation).
(Date of Issue of Permit).
11/19/40
19 | HEREBY CERTIFY.
That I attended deceased from
may 29, 1939
to.
hoventier 19
19.
40
I last saw hu ?...... alive on ..
november 19 1940 eath is said
to have occurred on the date stated above, at.
3:100%
V.m.
Immediate cause of death ....
Carcinoma o Sigmoid
Duration IMPORTANT 6 mos
Due to
13 NAME OF
FATHER
George S. Scoville
14 BIRTHPLACE OF
FATHER (City)
Tylerville
(State or country)
Conn.
What test confirmed dias
Clinical
Underline the cause to ich death
PARENTS
15 MAIDEN NAME
OF MOTHER
Katherine Hackett
16 BIRTHPLACE OF
MOTHER (City)
Hartford
(Signed)
63562 Hurley ST., Men Datgo "/19/04-0
(A
LOAZ John @gmailel
3
PLACE OF DEATH
CERTIFICATE OF DEATH
Hospital
St.
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No ..
(Usual place of abode)
Hospital
MARRIED
WIDOWED
or DIVORCED Single
Female
8
AGED9
Years
Months.
Days
Il Social Security No.
2 - 3
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 iliness, 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 hy 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 hury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not heen 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 hody and remove it from a town, from one cemetery to another, or from one grave or tomh other than the receiving tomb to ancther 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 heen de- livcred to such hoard, agent or clerk, as the casc may be, a satisfac- tory written statement containing the facts required by law to be returned and recorded, which shall he 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 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 early enough for the purpose, the certificate of death madc 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 obtaincd hercunder. 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 thercafter 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 he huried or the funeral is to be held, or from a person appointed to have the care of the cemetery or hurlal 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 ohserv- 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 disahled by recognized disease un- related 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 Examinors 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- mla), 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 suddon deaths of persons not disublod 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.
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 busi- ness, report the usual occupation prior to retirement. Children not gainfully employed may he returned as at school or at home. For a wonian 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
IR-301 A
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 ..
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. 212
Registered No § (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME
WilliamBunker Barron
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
10 Moore
(Usual place of abode)
Marital
years
months
1
days.
In this community 20
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Male
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
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 ... 40 Years.
2
.Months.
.Days
If less than 1 day
Hours
Minutes
Dueto With rupture and meningitis 24h
9 Occupation :
Carpenter
10 or Business:
11 Social Security No ..
032-03-3810
12 BIRTHPLACE (City)
Chelsea
(State or country) Massachusetts
13 NAME OF
FATHER Pierce P. Barron
PARENTS
17 Relation, if any
Informant. Charles A. Barron ( brother)
(Address) 159 Gold St South Boston
I HEREBY CERTIFY that a satisfactory standard certificate of death way,filed with me BEFORE the burial or transit permit was issued : Man D' Clubdress X (Signature of Agent of Board of Health of other) Health Affecter 11/2//40
(Official Designation) (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
19
40
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deceased from
11-18
19
440.
19
19.
.. 40
I last saw h .... ][2.alive on
11-19
19 ...... death is said to
have occurred on the date stated above, at ....
11:30 p.m.
Immediate cause of death. Ethmoiditis
Duration
IMPORTANT
6
wks
due to the pneumococcus
and terminal broncho-pneu-
Due to ... monia-
24 hrs
Other conditions.
none
(Include pregnancy within 3 months of death)
IMPORTANT
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 ?... NO.
If so, specify
(Signed)
89 Somerset Av
M. D.
(Address)
........ Dato .. 1-21-19 40
21 Winthrop Cemetery Winthrop
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIALNovember 22
1940
19
22 NAME OF
FUNERAL DIRECTOR
Charles R. Bennison
ADDRESS
Winthrop Mass
Received and filed. 19
(Registrar)
1
Winthrop
(City or Town)
No.Winthrop Community Hospital
St.
(If U. S.
War Veteran,
St
(If nonresident, give city or town and state)
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