USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1941 > Part 16
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Date of.
6 Age of husband or wife if alive.
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, furnisb for registration a standard certificate of death. stating to the best of his knowledge and helief 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 bis 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 suchi 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 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 hoard. agent or clerk, as the case may he, 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, 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 board of health, or em- ployed hy it or by the selectmen for the purpose, shall upon application make 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 human hody, 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 ahove 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 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 hody 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 fortlıwith 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 otber person shall bury a buman body or the ashes tbereof which have been brought into the commonwealth until he has received a permit so to do froni the board of health or its agent appointed to issue such permits, or if there is no such board, froin the clerk of the town where the body is to be buried or the funeral ls to be held, or from a person appointed to bave 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 tbe observance of the following rules of practice:
(1) Attending physicians will certify to such deatbs 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 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 bome when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. Thesc 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, hut also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled 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 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 tbe 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
M R-301 A |
is very important. See instructions and extracts from the laws on back of certificate.
PLACE OF DEATH
Suffolk
(County)
Winthrop
(City or Town)
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.
45
Registered No
§ (If death occurred in a hospital or institution,
St. { give its NAME instead of street and number)
2 FULL NAME
Jennie S. Larkin
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
10 Beacon St
St
(If nonresident, give city or town and state)
In this community 25 yrs.
mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
3 SEX
Female
4 COLOR OR RACE
White
5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED Ingle
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
AGE65
Years
Months.
Days
If less than 1 day
Hours
Minutes
Usual
Seamstress.
9 Occupation :
Industry
10 or Business:
11 Social Security No.
None
12 BIRTHPLACE (City)
(State or country)
England
13 NAME OF
FATHER
Patrick W.Larkin
PARENTS
14 BIRTHPLACE OF
FATHER (City)
(State or country)
England
15 MAIDEN NAME
OF MOTHER
Ann Corcoran
16 BIRTHPLACE OF
MOTHER (City) ..
(State or country)
Ireland
$17
Elizabeth Larkin Sister
(Address)
10 Beacon St Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Www. S. Chil dress Signature/of/Agent of Board of Health or other)
Vealthe Officer 2/24/41
(Official Designationy (Date of Issue of Permit)
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH
Febuary
22
(Month)
(Day)
(Year)
19 -I HEREBY CERTIFY. That I attended deceased from
19 ....... , to .................
194/
,
‹
I last saw h .......... . alive on .2., 19 .,)death is said to have occurred on the date stated above, at ....................... m. Immediate cause of death.
Duration IMPORTANT
Due to.
Due to.
Other conditions Niash 2118
(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 ?. If so, specify
(Signed)
M. D.
(Address).
1
Date-2-2019
21. St. Joseph's Boston
Place of Burial, Cremation or Removal. Febuary
25 19
(City or Town)
DATE OF BURIAL
19
22 NAME OF
W. J. Cassidy
FUNERAL DIRECTOR.
ADDRESS
160 Harrison Ave Boston
Received and filed
19
(Registrar)
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
information should be carefully supplied. AGE should be stated EXACTLY. PHYSICIANS should state
100m-2-'40-D-729-a
Relation, if any
Of autopsy
What test confirmed diagnosis ?.
70
Major findings: Of operations ..
Date of
1941
(If U. S.
War Veteran,
specify WAR)
No
Winthrop
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
1
No 10 Beacon St
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 whichi he died, definded as required by 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 hury or otherwise dispose of a human body in a town, or remove therefrom a human hody 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 huinan hody and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiv- ing 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 hody is huricd. 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 hy law to be returned and recorded, which shall he accompanied, in casc 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 hoard 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 hy 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 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 body shall be returned to the town froin which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the re- moval of such hody has heen 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 hoard of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transinit 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).
SPACE FOR ADDITIONAL INFORMATION
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 hody is to he huried 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 hedside 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 by 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 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 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 cf 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.
Winthrop, Ocean 1100
200 Washington Ave.
Dr.Edward J. Grainger
M R-302
PLACE OF DEATH
LUNI (County)
(City or Town)
The Commonwealth of Massachusetts OFFICE OF THE SECRETARY DIVISION OF VITAL STATISTICS COPY OF CERTIFICATE OF DEATH
BOSTON'
(City or towa making return)
Registered No ..
2157
(If death occurred in a hospital or institution,
give its NAME instead of street and number)
(If deceased is a married, widowed or divorced woman, give also maiden name.) 34 Pleasant
(a) Residence. No ......
(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
4 COLOR OR RACE 5 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED married
18 DATE OF
DEATH
Feb 22 1941
(Month)
(Day)
(Year)
19
BY CERTIFY,
19
Thatd perleAligceased from
I last saw h ............ alive on
er
2/22/41
19 ..
death is said
13.
(or) WIFE of
Timothy ..... O .!. Tog.1.
(Husband's name in full e.
.years
If less than 1 day
Hours.
Minutes
at home
Due to
Due to
Other conditions
(Include pregnancy within 3 months of death)
PHYSICIAN
Major findings :
Of operations
Date of.
Of autopsy
What test confirmed diagnosis ?.
20 Was disease or lajury In any way related to occupation of deceased ?
If so, specify.
(Signed)
W T S Thorndike
M. D.
(Address)
Boston
Date.
19
21 PLACE OF BURIAL,
CREMATION OR REMOVAL ..
HolyCross ..... Malden
DATE OF BURIAL
(Ceze 25/41
(City or Town) 19
22 NAME OF
FUNERAL DIRECTOR
J F' O'Maley
ADDRESS
Winthrop Mass
Received and Flød
19
(Registrar of City or Town where deceased resided)
Duration
.32 .... mos
12 BIRTHPLACE (City)
No.v.a ... S.co.t.i.a
13 NAME OF
FATHER
Hugh MacDonald
15 MAIDEN NAME
OF MOTHER
Grace MacDonald
Relation, if any
TRUE COPY.
ATTESTI
C
(Registrar of city of town where death occurred)
DATE FILED
2/26/41
19
.....
St.
Winthrop
(I U. S.
War Veteran,
specify WAR)
Mass
(If nonresident, give city or town and state)
Flora
O'Toole
St. (
No .... Mass General Hospital
2 FULL NAME
3 SEX
fem
white
5a If married, widowed, or divorced
HUSBAND of
6 Age of husband or wife ff alive.
7 IF STILLBORN, enter that fact here.
8
AGE ... 6.7.
.. Years
Months
Days
Usual
9 Occupation:
Industry
10 or Business:
....
11 Social Security No.
(State or country)
14 BIRTHPLACE OF
FATHER (City)
16 BIRTHPLACE OF
PARENTS
MOTHER (City)
(State or country)
17
Informant.
husband
(Address)
50m-10-'39. No. 2427-f
Copies of returns of deaths which occurred in your city or town in case the deceased resided in another city or town at the time
after the close of the month in which the death occurred. (See Chap. 46, Sec. 12, G. L.)
of death should be transmitted on Form R-302 to the clerk of the city or town in which the deceased resided as soon as possible
(State or country)
NS
(Give maiden name of wife in full)
to have occurred on the date stated above, at 7/30Pm. Immediate cause of death carcinoma ... o.f ..... the .... stomach
Underline the cause to which death should be charged sta- tistically.
RM R-301 A
PLACE OF DEATH
Suffolk (County)
Winthrop
(City or Town)
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.
47
Registered No § (If death occurred in a hospital or institution, { give its NAME instead of street and number)
2 FULL NAME
Elizabeth Atherton Tancred
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
14 Egleton Park
St
(If nonresident, give city or town and state)
(Usual place of abode)
Length of stay: In hospital or institution.
(Specify whether)
years
months
days.
In this community 1
yrs.
6 mos.
days.
PERSONAL AND STATISTICAL PARTICULARS
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)
(Husband's name in full)
6 Age of husband or wife if alive.
years
7 IF STILLBORN, enter that fact here.
AGE
56 Years
11 Months
6
Days
Hours.
.Minutes
9 Occupation :
None
11 Social Security No.
BOSTON
12 BIRTHPLACE (City)
(State or country)
MASS
13 NAME OF
FATHER
Peter Tancred
14 BIRTHPLACE OF
FATHER (City) ...
Boston
(State or country) Mass.
15 MAIDEN NAME
OF MOTHER
Elizabeth A. French
16 BIRTHPLACE OF MOTHER (City) (State or country) Mass
Relation, if any
Informant Charles F. Tancred Brother (Address) 14 Egleton PK. winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Www.S. Childreng
(Signature of Agent of Board of Health or other)
3/24/41
MEDICAL CERTIFICATE OF DEATH
18 DATE OF
DEATH.
February
23.1941
(Month)
(Day)
(Year)
19 I HEREBY CERTIFY. 1-14-41, 19 ., to.
That I attended deceased from
2-23
19 41
I last saw h.M alive on 2-23 19.41, death is said to have occurred on the date stated above, at 130 m.
Immediate cause of death
items
Due to.
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 ?.
20 Was disease or injury in any way related to occupation of deceased ?.
If so. specify.
(Signed).
(Address)
21.
Forest Hills
Boston
Place of Burial, Cremation or Removal.
(City or Town) 25
141.
22 NAME OF
FUNERAL DIRECTOR
DATE OF BURIAL ..
February.
Walter N. Jeg
ADDRESS Newtonville
Received and filed
19
(Registrar)
V
Underline the cause to which death should be charged sta- tistically.
M. D.
Date.
12/03 19
S. Boston
Health Office (Official Designation) (Date of Issue of Permit)
.....
(If U. S. War Veteran, specify WAR)
St.
No.
14 Egleton Park
Ellen
1 3 SEX Female (or) WIFE of. 8 Usual PARENTS 17 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. N. B .- WRITE PLAINLY, WITH UNFADING BLACK INK-THIS IS A PERMANENT RECORD. Every item of Industry 10 or Business :.. 100m-2-'40-D-729-8
Duration IMPORTANT
If less than 1 day
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS
GOVERNING THE
RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer shall forthwith, after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for 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 toinb 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 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).
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