USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1940 > Part 67
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CERTIFICATE OF DEATH
St. {
2 FULL NAME
James Cassels Higgins
(a) Residence. No.
(Usual place of abode)
years
months
days.
In this community 24 yrs.
mos.
days.
18 DATE OF December.
17
Margaret Lennon
.years
PARENTS
Dicland
,
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 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- livered to such board, agent or clerk, as the case nay 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 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 onc 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 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 been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit Is so given and the physician certifying the cause of death shall thereafter fur- nish for registration any other necessary information which can 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., (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 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, Seo. 46, G. L., (Tercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical attendanee or whose physician is absent from home when the certificate of death Is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septice- mia), and by the action of chemical (drugs or poisons), thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from Injury or infection 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 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 Ocenpation .- 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 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 nons.
SPACE FOR ADDITIONAL INFORMATION
R-301 A
SufTULK
(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, 226
Registered No.
(If death occurred in a hospital or institution, give its NAME instead of street and number)
2 FULL NAME
Eliza A ( Letson ) Letson
(If deceased is a married, widowed or divorced woman, give also maiden name.)
I86 Bartlett Rd.
.........
St.
(If nonresident, give city or town and state)
Length of stay : In hospital or institution.
(Specify whether)
years
months
days.
In this community26
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
4 COLOR OR RACE
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Widow
Female
White
5a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
HenryF Letson
(Husband's name in full)
Years
6 Age of husband or wife if alive.
7 IF STILLBORN, enter that fact here.
8
74
If less than 1 day
AGE 75
Years. . 9.
Months ..
2 ... Days
Hours
Minutes
9 Occupation:
Housewife
10 or Business:
Own Home
11 Social Security No.
12 BIRTHPLACE (City)
Chatham
(State or country)
New Brunswick
13 NAME OF
FATHER
Francis Josnia Letson
14 BIRTHPLACE OF
FATHER (City)
(State or country)
New Brunswick
15 MAIDEN NAME
OF MOTHER Isabella Jane Kerr
16 BIRTHPLACE OF
MOTHER (City)
Chatnam
(State or country)
New Brunswick
17 James Letson
Relation, if any
Son
(Address)9 Ingleside Ave
Winthrop
V
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 (Signature of Agent of Board of Health other)
He atthe Officer 12/20/40
(Official Designation) (Date of Issue of Permit)
18 DATE OF
DEATH
December
17
(Month)
(Day)
1940
(Year)
19 I HEREBY CERTIFY.
That I attended deceased from
Left. 1. 19.40, to December 17, 1940 I last saw ber alive on December (3, 1940, death is said to have occurred on the date stated above, at 2:40 P.m. Duration IMPORTANT Immediate cause of death. Congestive Heart Failure
Due to Coronar occlusion
3+mos
2
Due to
Generalized arteriosclerosis.
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Of autopsy
What test confirmed diagnosis? clinical
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.
....
21
Winthrop
Place of Burial, Cremation or Removal
DATE OF BURIAL Dec.
20
(City or Town)
1940
22 NAME OF
Howard S Purollo
FUNERAL DIRECTOR
ADDRESS.
......
......
Received and filed. LILU AO 1940
19
(Registrar)
ILLI VILLIGLIVIL N. R .- WRITE. PI.AINI.Y WITH UNFADING BLACK INK __ THIS IS A PERMANENT RECORD UG Laiciunly Suppleu.
1 Letson 3 SEX Usual PARENTS uge corrected as fear phonecall from James 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 No. 8427-e
100m16-'39.
PLACE OF DEATH
Winthrop
(City or Town)
No. 186 Barufelt
Rd.
St.
(If U. S.
War Veteran,
specify WAR)
(a) Residence. No.
(Usual place of abode)
MEDICAL CERTIFICATE OF DEATH
.........
If so, specify ..
(Signed)
(Address) Minthogy Muse Date 12/1/9/1940
Winthrop
Date of.
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith. after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for regis- tration a standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died. acfined as required by scction 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 buricd. No such permit shall be issued until there shall have been de- iivered 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 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 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 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 frem 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 certifleate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made. ... Chap. 114, Sec. 46. G. L., (Tercentenary Edition)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical 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 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 be returned as at school or at home. For a woman whose only occupation was that of home housework, write housewerk. 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
OM R-301
Every nem v1
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
N. 5 .- WKIIL PLAINLI, WITH ONPAVING DLACN INA-IHIJ IN A I LAMANCHI RECUAD. PARENTS 200m-10-'39. No. 8427-d
4 ....
JAN
1
PLACE OF DEATH
2 FULL NAME
ength of stay : In hospital or institution
3 SEX
4 COLOR OR RACE
White
Male
(or) WIFE of.
(Husband's name in full)
6 Age of husband or wife if alive.
75
7 IF STILLBORN, enter that fact here.
8
AGE.
79
Years
Months.
Days
Usual
9 Occupation:
Retired
10 or Business:
II Social Security No.
none
12 BIRTHPLACE (City)
Boston
(State or country)
14 BIRTHPLACE OF
FATHER (City)
(State or country)
Informant ...
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
Hotel operator
REVERE HO !!
1941
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
(City or town making return) ....
Registered No ... 227
(If death occurred in a hospital or institution, St. l
give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ... 15 Crescent are.
(Usual place of abode)
Hospital
years
months
4
days.
In this community yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
(write the word)
married
Sa If married, widowed, or divorce In Simmons
HUSBAND of
....
(Give maiden name of wife in full)
If less than 1 day
Hours.
Minutes
13 NAME OF
FATHER
Jeremiah mahoney
Ireland
15 MAIDEN NAME
OF MOTHER
mary Ward
16 BIRTHPLACE OF
MOTHER (City)
(State or country)
Ireland
17 Idal Mahoney Relation, if any (Address) 15 Crescent One, Benakmens
I HEREBY CERTIFY that a satisfactory standard certificate of death, was Hled with me BEFORE the burial or transit permit was Ionwody
ADRIAN E. CRAMPTON WWW. D. Children
ignature of Agent of Board of Health on other) EG 201940 Health Offices Received and filed.
.19
(Official Derienation BOSTONSTEALTH DEPT. (Date of Issue of Permit) 122/44 A TRUE COPY ATTEST:
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
December 18
1940
(Month)
(Day)
(Year)
19 IHEREBY CERTIFY. That I attended deceased from
September 10
Are
18
1970
to ..
1940
....
I last saw h ............ alive on.
Dec 18
1940
to have occurred on the date stated above, at.
9.001
.. m.
Years Immediate cause of death .. Lothar 1 neu
12-14-40
Due to
Lecuidan anemia
Duerto
Other conditions
(Include pregnancy within 3 months of death)
Major findings :
Of operations
Date of .....
.......
Of autopsy
What test confirmed diagnosis ?
20 Was disease or Injury In any way related to occupation of deceased ? 200
If so, specifyLa 2 Pa Lattina
M. D.
(Signed)
ess) Kevere Mars
12 -14
1940
Date.
.........
21
Woodlawiens Everetta
Place of Burial, Cremation or Removal.
(City or Town)
DATE OF BURIAL
Dec 21
1940
.....
22 NAME OF
FUNERAL DIRECTOR
QPic, Kinh
ADDRESS Boston, Suado
PHYSICIAN
Underline the cause to which death should be charged sta- tistically.
......
Duration
...
Many par ....
(Registrar)
War Veteran.
specity .WAR) ...........
mars
St.
Kever
(If nonresident, give city or town and state)
(Specify whether)
Suffolk (County)
Winthink (City or Town) Hunthink Community Norkelals. No. John J Mahoney
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
death is said
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 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 perinit 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 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 eannot 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 a removal shall constitute a permit for such removal ; provided, that such body shall be returned to the town from which it was removed within thirty- six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the death certificate contains a recital, as required by section ten of chapter forty-six, that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registration. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter fur- nish for registration any other necessary information which can be
obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition.)
No undertaker or other person shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made .... Chap. 114, Sec. 46, G. L., (Tercentenary Edition.)
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observ- ance of the following rules of practice :
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last ill- ness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease un- related to any form of injury, have died without recent medical 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.
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