USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 15
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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 disahled by recognized disease unrelated to any form of injury, have died without recent medical attendance or wbose physician is ahsent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposahly due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons), thermal. or electrical agents. and deaths following abortion, hut also deaths from discase 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 deatb means the disease, or complication which causes death, not the mode of dying, e. g., heart failure, asphyxia, asthenia, etc. As principal cause name the disease causing death. As related causes, name earlier morhid conditions, if any,. related to the principal cause and any important complication of the principal cause.
Statement of Occupation .- Precise statement of occupation is very important, 80 that the relative bealthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. if the occupation had been given up or changed on account of the disease causing death, report the usual occupation prior to illness. If the deceased had retired from business, report the usual occupation prior to retirement. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation hy the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION.
M R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
No. 387 Shirley St
The Commonwealth of Massarquartta OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
Registered No.
( (If death occurred in a hospital or institution, St. [ give its NAME instead of street and number)
2 FULL NAME
Ellen A. ( Reed ) Gerth
(If deceased is a married, widowed or divorced woman, give also maiden name.)
387 Shirley St.
St
(If nonresident, give city or town and state)
20
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY.
That I attended deceased from
0172446 2 19. ........ ,
to ...... F.rd 19
I last saw halive on
1., 19
., death is said to
have occurred on the date stated above, at.
Immediate cause of death
m.
Duration IMPORTANT
Due to.
uterus
Due to.
Other conditions.
(Include pregnancy within 3 months of death)
Major findings: Of operations
Underline the cause to which death
Of autopsy
What test confirmed diagnosis?
tres
should be charged sta- tistically.
20 Was disease or injury in any way related to occupation of deceased ?.
If so, specify ..
(Signed)
(Address)
M. D.
21 Winthrop
winthrop
Place of Burial, Cremation or Removal.
(City or Town)
February-21
41
19
22 NAME OF
DATE OF BURIAL ...
John F. OMaler
FUNERAL DIRECTOR ... ,
ADDRESS.
Winthrop Massachusetts
Received and filed
19
(Registrar)
IMPORTANT PHYSICIAN
12 BIRTHPLACE (City)
(State or country)
Massachusetts
13 NAME OF
FATHER
George Reed
14 BIRTHPLACE OF
FATHER (City) .......
(State or country)
Massachusetts
Lynn
15 MAIDEN NAME
OF MOTHER
Cannot be learned
Lynfield
16 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
Massachusetts
Relation, if any
Informant ..
(Address)
387 Shirley St.,
inthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. D. Children
(Signature of Agent of Board of Health or other) Health Officer 2/20/41
(Official Designation) (Date of Issue of Permit)
5 SINGLE
(write the word)
MARRIED Widowed
WIDOWED
or DIVORCED
5a If married, widowed, or divorced HUSBAND of ...
(Give maiden name of wife in full)
(or) WIFE of.
Harry
Gerth
(Husband's name in full)
6 Ago of husband or wife if alive.
.. years
7 IF STILLBORN, enter that fact here.
60
Years.
Months.
Days
If less than 1 day Hours Minutes
Usual
9 Occupation :
Liner
Furs
11 Social Security No.
011-12-0390
Danvers
Date of.
Dato ...............
19
17 Charles Carter
1 3 SEX Female AGE PARENTS CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. 100m-2-'40-D-729-8 N. B .- WRITE PLAINLY, WITH ONFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of Industry 10 or Business:
4 COLOR OR RACE
White
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
(If U. S.
War Vetsran.
specify WAR)
years
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 dicd, defined as required by section onc, 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 thercfrom 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 lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient, a physician who is a member of the board of health, or em- ployed by it or 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 scction 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 .- Chop. 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 septiccmia), 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 causcs, 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
M R-301 A
PLACE OF DEATH
Suffolk
The Commonwealth of Massarhusetta OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial parmit with Board of Health or its Agent.
43
Registered No
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME
Elizabeth Lynn Mackay
(If deceased is a maryled, widowed or divorced woman, give also maiden name.)
24 Beals St., Winthrop
St.
(If nonresident, give city or town and state)
months
12 days.
In this community
yrs.
mos/2days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF Feb. 19, 1941
DEATH.
(Month) (Day)
(Year)
19 I HEREBY CERTIFY. 0 That I attended deceased from 2/7, 1941, to Leb. 19 19.41
I last saw h Or alive on
Feb 19
19.2./ .. , death is said to
have occurred on the date stated above, at.
6:15 P.M
.m.
Immediate cause of death dehydration
Due to. Spina bifida
Due to. hydrocephalus
Other conditions.
(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? the
If so, specify
(Signed)
Winthrop, mass Date.
2 /20 1971
(Address)
21. Winthrop Winthrop
Place of Burial, Cremation or Removal. (City or Town)
DATE OF BURIAL
Feb. 21, 1941
19
22 NAME OF FUNERAL DIRECTOR. Micha
ADDRESS 147 Winthrop St. Winthp
Received and filed
19
(Registrar)
(County) 1 Winthrop (City or Town) ..... 3 SEX 4 COLOR OR RACE Female White (or) WIFE of. 6 Age of husband or wife if alive. 7 IF STILLBORN, enter that fact here. 12 8 AGE .Years .. Monthe Days Usual 9 Occupation: Industry 10 or Business: 11 Social Security No .. 13 NAME OF FATHER Franklin Mackay 14 BIRTHPLACE OF FATHER (City) OF MOTHER PARENTS 16 BIRTHPLACE OF Roxbury MOTHER (City) (State or country) 17 Franklin Mackay Informant 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. information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state 100m-2-'40-D-729-a N. D .- WRITE PLAINTEA, WITIT ONPAVING DEAVA INK-THIS IS A PERMANENT RECORD. Every item of (State or country) Mass.
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDSingle
Sa If married, widowed, or divorced HUSBAND of ...... (Give maiden name of wife in full)
(Husband's name in full)
.years
If less than 1 day Hours Minutes
NAthrop -Commaity Hangi ..
12 BIRTHPLACE (City)
(State or country)
Winthrop, Mass.
East Boston
15 MAIDEN NAME Henrietta Bordeau
MASS.
Relation, if any Father
(Address)
24 Beale St., Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued :
(Signature of Agent of Board of Health or other)
Health Milicer 2/21/41
(Official Designation) (Date of Issue of Permit).
Duration IMPORTANT
genital
Major findings:
Of operations
none
Date of
Of autopsy.
none
What test confirmed diagnosis?
clinical
M. D.
No. Winthrop Comunity Hospital
St.
(If U. S. War Veteran, specify WAR)
(a) Residence. No.
(Usual place of abode)
Length of stay: In hospital or institution.
Hospital years
(Specify whether)
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 hag not been buried, until he has received a permit froin 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 inay 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 lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is in- sufficient. a physician who is a member of the board of health, or em- ployed by it or 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 inake 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 perinit 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 froin 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 physiclans 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 deathis 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
RM R-301 A
PLACE OF DEATH
Suffolk.
(County)
Winthrop.
(City or To .
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.
44
Registered No.
§ (If death occurred in a hospital or institution, ¿ give its NAME instead of street and number)
2 FULL NAME
Charles
Nourse.
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
18
Tewksbury
St
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community
yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH ..
21
1941
(Month)
(Day)
(Year)
Sa If married, widowed or diverse HUSBAND of.
E. Looker
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
years
7 IF STILLBORN, enter that fact here.
AGE
Years
Months.
.Days
If less than 1 day Hours .Minutes
9 Occupation:
Metal
Worker.
10 or Business :.
Factory
11 Social Security No ...
12 BIRTHPLACE (City)
(State or country)
New ... New York.
mity
13 NAME OF
FATHER
John M. Nourse.
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Alice R. Kennedy.
16 BIRTHPLACE OF
MOTHER (City).
(State or country)
Ireland.
17 Mary Gills
Informant
(Address)
18 Tewksbury Street Winthro
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued:
Wela
Childrens
(Signature of Agent of Board of Health or other)
agent Free- 22/4/
(Official Designation)
(Date of Issue of Permit)
19 I HEREBY CERTIFY. That I attended deceased from
Sam . 26 1941 to Feb 21. 1941
I last saw him alive on feb 21 19.4/ ..! , death is said to have occurred on the date stated above, at. 9.30 p.m.
Duration
Immediate cause of death. Broncho-pruumowa
IMPORTANT
Due to.
La Griffe
Jan 22-41
Due to ...
Chronic ascliente
1900
Other conditions Manual arterioscabezacio 1930
(Include pregnancy within 3 months of death)
Major findings:
Of operations
none
Of autopsy.
none.
What test confirmed diagnosis?
Clinical
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? 200 .......
If so, specify,
2/21
(Signed)
(Address) Wundert mass
.......... Date ......
19.42 ª
M. D.
St. Peters Cemetery, New Brunswick
Place of Burial, Cremation or Removal.
(City or Town)
N.J
DATE OF BURIAL
Feb. 24
1941
22 NAME OF
FUNERAL DIRECTOR ...
S. Waterman
( Sona,
ADDRESS
Boston
mass.
Received and filed. 19
(Registrar)
1 3 SEX Male 8 82 Usual PARENTS information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state is very important. See instructions and extracts from the laws on back of certificate. CAUSE OF DEATH in plain terms, so that it may be properly classified. Exact statement of OCCUPATION 100m-2 -* 40-D-729-a N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of Industry
No.
18
Tewksbury
St.
(If U. S.
War Veteran,
specify WAR)
none
Jinthnon.
(If nonresident, give city or town and state)
17
4 COLOR OR RACE
White
5 SINGLE
MARRIED
WIDOWED
or DIVORCED
(write the word)
Widower
Relation, if any
(
Daughter
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